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1. Whole genomes from bacteria collected at diagnostic units around the world 2020

Author: Nag, S, Larsen, G, Szarvas, J, Birkedahl, L, Gulyas, G, Ciok, W, Lagermann, T, Tafaj, S, Bradbury, S, Collignon, P, Daley, D, Dougnon, V, Fabiyi, K, Coulibaly, B, Dembele, R, Nikiema, G, Magloire, N, Ouindgueta, I, Hossain, Z, Begum, A, Donchev, D, Diggle, M, Turnbull, L, Levesque, S, Berlinger, L, Sogaard, K, Guevara, P, Valderrama, C, Maikanti, P, Amlerova, J, Drevinek, P, Tkadlec, J, Dilas, M, Kaasch, A, Westh, H, Bachtarzi, M, Amhis, W, Salazar, C, Villacis, J, Luzon, M, Palau, D, Duployez, C, Paluche, M, Asante-Sefa, S, Moller, M, Ip, M, Marekovic, I, Pal-Sonnevend, A, Cocuzza, C, Dambrauskiene, A, Macanze, A, Cossa, A, Mandomando, I, Nwajiobi-Princewill, P, Okeke, I, Kehinde, A, Adebiyi, I, Akintayo, I, Popoola, O, Onipede, A, Blomfeldt, A, Nyquist, N, Bocker, K, Ussher, J, Ali, A, Ullah, N, Khan, H, Gustafson, N, Jarrar, I, Al-Hamad, A, Luvira, V, Paveenkittiporn, W, Baran, I, Mwansa, J, Sikakwa, L, Yamba, K, Hendriksen, R, Aarestrup, F, Nag S., Larsen G., Szarvas J., Birkedahl L. E. K., Gulyas G. M., Ciok W. J., Lagermann T. M., Tafaj S., Bradbury S., Collignon P., Daley D., Dougnon V., Fabiyi K., Coulibaly B., Dembele R., Nikiema G., Magloire N., Ouindgueta I. J., Hossain Z. Z., Begum A., Donchev D., Diggle M., Turnbull L. A., Levesque S., Berlinger L., Sogaard K. K., Guevara P. D., Valderrama C. D., Maikanti P., Amlerova J., Drevinek P., Tkadlec J., Dilas M., Kaasch A., Westh H. T., Bachtarzi M. A., Amhis W., Salazar C. E. S., Villacis J. E., Luzon M. A. D., Palau D. B., Duployez C., Paluche M., Asante-Sefa S., Moller M., Ip M., Marekovic I., Pal-Sonnevend A., Cocuzza C. E., Dambrauskiene A., Macanze A., Cossa A., Mandomando I., Nwajiobi-Princewill P., Okeke I. N., Kehinde A. O., Adebiyi I., Akintayo I., Popoola O., Onipede A., Blomfeldt A., Nyquist N. E., Bocker K., Ussher J., Ali A., Ullah N., Khan H., Gustafson N. W., Jarrar I., Al-Hamad A., Luvira V., Paveenkittiporn W., Baran I., Mwansa J. C. L., Sikakwa L., Yamba K., Hendriksen R. S., Aarestrup F. M., Nag, S, Larsen, G, Szarvas, J, Birkedahl, L, Gulyas, G, Ciok, W, Lagermann, T, Tafaj, S, Bradbury, S, Collignon, P, Daley, D, Dougnon, V, Fabiyi, K, Coulibaly, B, Dembele, R, Nikiema, G, Magloire, N, Ouindgueta, I, Hossain, Z, Begum, A, Donchev, D, Diggle, M, Turnbull, L, Levesque, S, Berlinger, L, Sogaard, K, Guevara, P, Valderrama, C, Maikanti, P, Amlerova, J, Drevinek, P, Tkadlec, J, Dilas, M, Kaasch, A, Westh, H, Bachtarzi, M, Amhis, W, Salazar, C, Villacis, J, Luzon, M, Palau, D, Duployez, C, Paluche, M, Asante-Sefa, S, Moller, M, Ip, M, Marekovic, I, Pal-Sonnevend, A, Cocuzza, C, Dambrauskiene, A, Macanze, A, Cossa, A, Mandomando, I, Nwajiobi-Princewill, P, Okeke, I, Kehinde, A, Adebiyi, I, Akintayo, I, Popoola, O, Onipede, A, Blomfeldt, A, Nyquist, N, Bocker, K, Ussher, J, Ali, A, Ullah, N, Khan, H, Gustafson, N, Jarrar, I, Al-Hamad, A, Luvira, V, Paveenkittiporn, W, Baran, I, Mwansa, J, Sikakwa, L, Yamba, K, Hendriksen, R, Aarestrup, F, Nag S., Larsen G., Szarvas J., Birkedahl L. E. K., Gulyas G. M., Ciok W. J., Lagermann T. M., Tafaj S., Bradbury S., Collignon P., Daley D., Dougnon V., Fabiyi K., Coulibaly B., Dembele R., Nikiema G., Magloire N., Ouindgueta I. J., Hossain Z. Z., Begum A., Donchev D., Diggle M., Turnbull L. A., Levesque S., Berlinger L., Sogaard K. K., Guevara P. D., Valderrama C. D., Maikanti P., Amlerova J., Drevinek P., Tkadlec J., Dilas M., Kaasch A., Westh H. T., Bachtarzi M. A., Amhis W., Salazar C. E. S., Villacis J. E., Luzon M. A. D., Palau D. B., Duployez C., Paluche M., Asante-Sefa S., Moller M., Ip M., Marekovic I., Pal-Sonnevend A., Cocuzza C. E., Dambrauskiene A., Macanze A., Cossa A., Mandomando I., Nwajiobi-Princewill P., Okeke I. N., Kehinde A. O., Adebiyi I., Akintayo I., Popoola O., Onipede A., Blomfeldt A., Nyquist N. E., Bocker K., Ussher J., Ali A., Ullah N., Khan H., Gustafson N. W., Jarrar I., Al-Hamad A., Luvira V., Paveenkittiporn W., Baran I., Mwansa J. C. L., Sikakwa L., Yamba K., Hendriksen R. S., and Aarestrup F. M.
Abstract: The Two Weeks in the World research project has resulted in a dataset of 3087 clinically relevant bacterial genomes with pertaining metadata, collected from 59 diagnostic units in 35 countries around the world during 2020. A relational database is available with metadata and summary data from selected bioinformatic analysis, such as species prediction and identification of acquired resistance genes.
Published: 2023

2. The epidemiology of febrile illness in sub-Saharan Africa: implications for diagnosis and management

Author: Maze, M.J., Bassat, Q., Feasey, N.A., Mandomando, I., Musicha, P., and Crump, J.A.
Published: 2018
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3. Clinical features, risk factors, and impact of antibiotic treatment of diarrhea caused by Shigella in children less than 5 years in Manhiça District, rural Mozambique

Author: Vubil D, Acácio S, Quintó L, Ballesté-Delpierre C, Nhampossa T, Kotloff K, Levine MM, Alonso P, Nataro JP, Farag TH, Vila J, and Mandomando I
Subjects: Diarrhea, Shigella, epidemiology, Infectious and parasitic diseases, RC109-216
Abstract: Delfino Vubil,1 Sozinho Acácio,1,2 Llorenç Quintò,3 Clara Ballesté-Delpierre,3 Tacilta Nhampossa,1,2 Karen Kotloff,4 Myron M Levine,4 Pedro Alonso,1 James P Nataro,5 Tamer H Farag,4 Jordi Vila,3,6 Inacio Mandomando1,2 1Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; 2Instituto Nacional de Saúde (INS), Maputo, Mozambique; 3ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; 4Center for Vaccine Development (CVD), University of Maryland, School of Medicine, Baltimore, MD, USA; 5Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA; 6Department of Clinical Microbiology, Centre for Biomedical Diagnosis, Hospital Clinic, Barcelona, Spain Objectives: During the period from December 2007 to November 2012, the epidemiology of diarrhea caused by Shigella was studied among children
Published: 2018

4. Epidemiology and molecular characterization of multidrug-resistant Escherichia coli isolates harboring blaCTX-M group 1 extended-spectrum β-lactamases causing bacteremia and urinary tract infection in Manhiça, Mozambique

Author: Guiral E, Pons MJ, Vubil D, Marí-Almirall M, Sigaúque B, Soto SM, Alonso PL, Ruiz J, Vila J, and Mandomando I
Subjects: CTX-M-15, multidrug-resistance, Enterobacteriaceae, resistance determinant location, Infectious and parasitic diseases, RC109-216
Abstract: Elisabet Guiral,1 Maria Jesús Pons,1 Delfino Vubil,2 Marta Marí-Almirall,1 Betuel Sigaúque,2,3 Sara Maria Soto,1 Pedro Luís Alonso,1,2 Joaquim Ruiz,1 Jordi Vila,1,4 Inácio Mandomando2,3 1Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; 2Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; 3Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique; 4Microbiology Department, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain Background: The emergence and spread of extended-spectrum β-lactamases (ESBLs), especially CTX-M, is an important public health problem with serious implications for low-income countries where second-line treatment is often unavailable. Knowledge of the local prevalence of ESBL is critical to define appropriate empirical therapeutic strategies for multidrug-resistant (MDR) organisms. This study aimed to assess and characterize the presence of ESBL and especially CTX-M-producing Escherichia coli MDR isolates from patients with urinary tract infections (UTIs) and bacteremia in a rural hospital in Mozambique. Materials and methods: One hundred and fifty-one E. coli isolates from bacteremia and UTI in children were screened for CTX-M, TEM, SHV and OXA β-lactamases by polymerase chain reaction and sequencing. Isolates carrying CTX-M group 1 β-lactamases were further studied. The resistance to other antibiotic families was determined by phenotypic and genotypic methods, the location of the blaCTX-M gene and the epidemiology of the isolates were studied, and extensive plasmid characterization was performed. Results: Approximately 11% (17/151) of E. coli isolates causing bacteremia and UTI were ESBL producers. CTX-M-15 was the most frequently detected ESBL, accounting for 75% of the total isolates characterized. The blaCTX-M gene is located in different plasmids belonging to different incompatibility groups and can be found in non-epidemiologically related isolates, indicating the high capacity of this resistance determinant to spread widely. Conclusion: Our data suggest the presence of a co-selection of third-generation cephalosporin-resistant determinants in the study area despite limited access to these antibiotics. This highlights the importance of continuous surveillance of antimicrobial resistance of both genetic elements of resistance and resistant isolates in order to monitor the emergence and trends of ESBL-producing isolates to promote adequate therapeutic strategies for the management of MDR bacterial infections. Keywords: CTX-M-15, multidrug-resistance, Enterobacteriaceae, resistance determinant location
Published: 2018

5. Salmonella enterica serovars Typhimurium and Enteritidis causing mixed infections in febrile children in Mozambique

Author: García V, Mandomando I, Ruiz J, Herrera-León S, Alonso PL, and Rodicio MR
Subjects: Invasive non-typhoidal salmonellosis, Bloodstream infection, Multidrug resistance, Virulence-resistance plasmid, ST313, ST1479, Infectious and parasitic diseases, RC109-216
Abstract: Vanesa García,1 Inácio Mandomando,2,3 Joaquim Ruiz,4 Silvia Herrera-León,5 Pedro L Alonso,3,4 M Rosario Rodicio1 1Departamento de Biología Funcional, Área de Microbiología, Universidad de Oviedo, Oviedo, Spain; 2Centro de Investigação em Saúde de Manhiça, 3Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique; 4ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic, Universitat de Barcelona, Barcelona, 5Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain Background and purpose: Invasive nontyphoidal salmonellosis, mostly caused by serovars Typhimurium and Enteritidis of Salmonella enterica, has emerged as a major public health problem in sub-Saharan Africa. The aim of this study was the clinical and microbiological characterization of nontyphoidal salmonellosis episodes affecting febrile children in Mozambique. Patients and methods: The clinical records of the patients were evaluated, and S. enterica isolates were characterized with regard to serovar, phage type, antimicrobial resistance (phenotype/responsible genes), plasmid content, pulsed-field gel electrophoresis, and multilocus sequence typing. Results: Fifteen S. Typhimurium and 21 S. Enteritidis isolates were recovered from blood samples of 25 children, the majority with underlying risk factors. With regard to phage typing, most isolates were either untypeable or reacted but did not conform, revealing that a number of previously unrecognized patterns are circulating in Mozambique. Most isolates were multidrug-resistant, with nearly all of the responsible genes located on derivatives of serovar-specific virulence plasmids. ST313 and ST11 were the predominant sequence types associated with S. Typhimurium and S. Enteritidis, respectively, and the uncommon ST1479 was also detected in S. Enteritidis. A distinct XbaI fragment of ~350 kb was associated with pulsed-field gel electrophoresis patterns of multidrug-resistant isolates of S. Enteritidis. Nearly half of the children were coinfected with both serovars, a fact expected to aggravate the disease and hamper the treatment. However, particularly poor outcomes were not observed for the coinfected patients. Conclusion: Mixed Salmonella infections could frequently occur in febrile children in Mozambique. Additional studies are required to determine their actual impact and consequences, not only in this country, but also in other African countries. Keywords: invasive nontyphoidal salmonellosis, bloodstream infection, multidrug resistance, virulence-resistance plasmid, ST313, ST1479
Published: 2018

6. Surveillance of Acute Bacterial Meningitis among Children Admitted to a District Hospital in Rural Mozambique

Author: Roca, A., Bassat, Q., Morais, L., Machevo, S., Sigaúque, B., O'Callaghan, C., Nhamposa, T., Letang, E., Mandomando, I., Nhalungo, D., Quintó, L. I., and Alonso, P.
Published: 2009
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7. An adaptive phase II/III safety and efficacy randomized controlled trial of single day or three-day fixed-dose albendazole-ivermectin co-formulation versus albendazole for the treatment of Trichuris trichiura and other STH infections. ALIVE trial protocol

Author: Martínez Valladares, María [0000-0002-3723-1895], Krolewiecki, A., Enbiale, W., Gandasegui, Javier, van Lieshout, L., Kepha, S., Messa Junior, A., Bengtson, M., Gelaye, W., Escola, V., Martínez Valladares, María, Cambra Pelletjá, María, Algorta, J., Martí-Soler, H., Fleitas, P., Ballester, M.R., Doyle, S.R., Williams, N.A., Legarda, A., Mandomando, I., Mwandawiro, C., Muñoz, J., Martínez Valladares, María [0000-0002-3723-1895], Krolewiecki, A., Enbiale, W., Gandasegui, Javier, van Lieshout, L., Kepha, S., Messa Junior, A., Bengtson, M., Gelaye, W., Escola, V., Martínez Valladares, María, Cambra Pelletjá, María, Algorta, J., Martí-Soler, H., Fleitas, P., Ballester, M.R., Doyle, S.R., Williams, N.A., Legarda, A., Mandomando, I., Mwandawiro, C., and Muñoz, J.
Abstract: Background: Soil-transmitted helminths (STH) are targeted for control through mass drug-administration campaigns to prevent morbidity affecting at-risk groups in endemic regions. Although broadly successful, the use of albendazole and mebendazole achieved variable progress, with deficiencies against Trichuris trichiura and a predictable low efficacy against Strongyloides stercoralis. Novel drug combinations offer a potential solution, providing they can be delivered safely and maintain efficacy against all STH species. Here we present the protocol of a clinical trial to evaluate a fixed-dose combination (FDC) tablet containing albendazole and ivermectin that will be compared against albendazole against STH. Methods: An adaptive phase II/III randomized controlled trial will be undertaken in STH endemic sites in Ethiopia, Kenya and Mozambique to evaluate an oral FDC of 400 mg albendazole and either 9- or 18 mg ivermectin. FDC will be administered as a single dose or single doses over three-consecutive days and assessed against a single dose of 400 mg albendazole. In the phase II trial, 126 T. trichiura-infected children weighting 15 to 45 kg will be treated in a dose-escalation manner to determine safety objectives. In the phase III trial, 1097 participants aged 5 to 18 years old infected with T. trichiura, hookworm and S. stercoralis will be recruited to determine safety and efficacy. The trial will be open-label with blinded outcome assessors. Cure rate measured 21-days after-treatment in duplicate Kato-Katz is the primary efficacy outcome. Secondary objectives include efficacy evaluation by quantitative polymerase chain reaction (PCR) as an outcome measurement, description of pharmacokinetic parameters, palatability and acceptability evaluations, and monitoring of anthelmintic resistance. Conclusions: This trial with registrational goals seeks to evaluate an innovative fixed-dose combination of albendazole and ivermectin co-formulated tablets, with the goal of prov
Published: 2022

8. Prioritising health-care strategies to reduce childhood mortality, insights from Child Health and Mortality Prevention Surveillance (CHAMPS): a longitudinal study

Author: Madewell ZJ, Whitney CG, Assefa N, Bassat Q, Arifeen SE, Gurley ES, Jambai A, Kotloff KL, Madhi SA, Mandomando I, Ogbuanu IU, Onyango D, Scott JAG, Sow SO, Barr BAT, and Blau DM
Abstract: BACKGROUND: Globally, mortality in children younger than 5 years has been decreasing over the past few decades, but high under-5 mortality persists across regions of sub-Saharan Africa and southern Asia. Interventions-such as improved quality of clinical and antenatal care, better access to emergency obstetrical procedures, better triage and risk stratification, better immunisation coverage, or infection control measures-could substantially reduce deaths, but it is unclear which strategies could save the most lives. We aimed to use data from the Child Health and Mortality Prevention Surveillance (CHAMPS) network to examine which health-care and public health improvements could have prevented the most deaths. METHODS: We used standardised, population-based, mortality surveillance data collected by CHAMPS from seven sites (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) to understand preventable causes of death in children younger than 5 years. Deaths were investigated with minimally invasive tissue sampling, a post-mortem approach using biopsy needles for sampling key organs and body fluids. For each death, an expert panel reviewed case data to determine whether the death was preventable and (if preventable) provided recommendations as to how the death could have been avoided. We evaluated which health system improvements could have prevented the most deaths among those who underwent minimally invasive tissue sampling for each age group: stillbirths, neonatal deaths (aged
Published: 2022

9. Acute bacterial meningitis among children, in Manhiça, a rural area in Southern Mozambique

Author: Sigaúque, B., Roca, A., Sanz, S., Oliveiras, I., Martínez, M., Mandomando, I., Vallès, X., Espasa, M., Abacassamo, F., Sacarlal, J., Macete, E., Nhacolo, A., Aponte, J., Levine, M.M., and Alonso, P.L.
Published: 2008
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10. Breast milk and gut microbiota in African mothers and infants from an area of high HIV prevalence

Author: González, R, Mandomando, I, Fumadó, V, Sacoor, C, Macete, E, Alonso, P L, and Menendez, C
Published: 2014

11. Impact of CD14 promoter variants on measles vaccine responses and vaccine failure in children from Australia and Mozambique

Author: Clifford, H. D., Hayden, C. M., Khoo, S.-K., Naniche, D., Mandomando, I. M., Zhang, G., Richmond, P., and Le Souëf, P. N.
Published: 2013
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12. Antimicrobial resistance levels among diarrheogenic and commensal Escherichia coli from Southern Mozambique

Author: Pons, M. J., Mandomando, I., Vubil, D., Sigauque, B., Acacio, S., Nhampossa, T., Alonso, P. L., and Ruiz, J.
Published: 2011

13. Genetic and structural analysis of MBL2 and MASP2 polymorphisms in south-eastern African children

Author: Vallès, X., Sarrias, M.-R., Casals, F., Farnós, M., Piñer, R., Suárez, B., Morais, L., Mandomando, I., Sigaúque, B., Roca, A., Alonso, P. L., Torres, A., Thielens, N. M., and Lozano, F.
Published: 2009
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14. Mother-to-child transmission of HIV-1: association with malaria prevention, anaemia and placental malaria*

Author: Naniche, D, Lahuerta, M, Bardaji, A, Sigauque, B, Romagosa, C, Berenguera, A, Mandomando, I, David, C, Sanz, S, Aponte, J, Ordi, J, Alonso, P, and Menendez, C
Published: 2008

15. Safety and immunogenicity of the RTS,S/AS02A candidate malaria vaccine in children aged 1–4 in Mozambique

Author: Macete, E., Aponte, J. J., Guinovart, C., Sacarlal, J., Ofori-Anyinam, O., Mandomando, I., Espasa, M., Bevilacqua, C., Leach, A., Dubois, M. C., Heppner, D. G., Tello, L., Milman, J., Cohen, J., Dubovsky, F., Tornieporth, N., Thompson, R., and Alonso, P. L.
Published: 2007

16. Invasive pneumococcal disease in children <5 years of age in rural Mozambique

Author: Roca, A., Sigaúque, B., Quintó, Ll., Mandomando, I., Vallès, X., Espasa, M., Abacassamo, F., Sacarlal, J., Macete, E., Nhacolo, A., Levine, M., and Alonso, P.
Published: 2006

17. Diarrhoeal disease and subsequent risk of death in infants and children residing in low-income and middle-income countries: analysis of the GEMS case-control study and 12-month GEMS-1A follow-on study

Author: Levine, MM, Nasrin, D, Acacio, S, Bassat, Q, Powell, H, Tennant, SM, Sow, SO, Sur, D, Zaidi, AKM, Faruque, ASG, Hossain, MJ, Alonso, PL, Breiman, RF, O'Reilly, CE, Mintz, ED, Omore, R, Ochieng, JB, Oundo, JO, Tamboura, B, Sanogo, D, Onwuchekwa, U, Manna, B, Ramamurthy, T, Kanungo, S, Ahmed, S, Qureshi, S, Quadri, F, Hossain, A, Das, SK, Antonio, M, Saha, D, Mandomando, I, Blackwelder, WC, Farag, T, Wu, Y, Houpt, ER, Verweiij, JJ, Sommerfelt, H, Nataro, JP, Robins-Browne, RM, Kotloff, KL, Levine, MM, Nasrin, D, Acacio, S, Bassat, Q, Powell, H, Tennant, SM, Sow, SO, Sur, D, Zaidi, AKM, Faruque, ASG, Hossain, MJ, Alonso, PL, Breiman, RF, O'Reilly, CE, Mintz, ED, Omore, R, Ochieng, JB, Oundo, JO, Tamboura, B, Sanogo, D, Onwuchekwa, U, Manna, B, Ramamurthy, T, Kanungo, S, Ahmed, S, Qureshi, S, Quadri, F, Hossain, A, Das, SK, Antonio, M, Saha, D, Mandomando, I, Blackwelder, WC, Farag, T, Wu, Y, Houpt, ER, Verweiij, JJ, Sommerfelt, H, Nataro, JP, Robins-Browne, RM, and Kotloff, KL
Abstract: BACKGROUND: The Global Enteric Multicenter Study (GEMS) was a 3-year case-control study that measured the burden, aetiology, and consequences of moderate-to-severe diarrhoea (MSD) in children aged 0-59 months. GEMS-1A, a 12-month follow-on study, comprised two parallel case-control studies, one assessing MSD and the other less-severe diarrhoea (LSD). In this report, we analyse the risk of death with each diarrhoea type and the specific pathogens associated with fatal outcomes. METHODS: GEMS was a prospective, age-stratified, matched case-control study done at seven sites in Africa and Asia. Children aged 0-59 months with MSD seeking care at sentinel health centres were recruited along with one to three randomly selected matched community control children without diarrhoea. In the 12-month GEMS-1A follow-on study, children with LSD and matched controls, in addition to children with MSD and matched controls, were recruited at six of the seven sites; only cases of MSD and controls were enrolled at the seventh site. We compared risk of death during the period between enrolment and one follow-up household visit done about 60 days later (range 50-90 days) in children with MSD and LSD and in their respective controls. Approximately 50 pathogens were detected using, as appropriate, classic bacteriology, immunoassays, gel-based PCR and reverse transcriptase PCR, and quantitative real-time PCR (qPCR). Specimens from a subset of GEMS cases and controls were also tested by a TaqMan Array Card that compartmentalised probe-based qPCR for 32 enteropathogens. FINDINGS: 223 (2·0%) of 11 108 children with MSD and 43 (0·3%) of 16 369 matched controls died between study enrolment and the follow-up visit at about 60 days (hazard ratio [HR] 8·16, 95% CI 5·69-11·68, p<0·0001). 12 (0·4%) of 2962 children with LSD and seven (0·2%) of 4074 matched controls died during the follow-up period (HR 2·78, 95% CI 0·95-8·11, p=0·061). Risk of death was lower in children with dysenteric MSD than in ch
Published: 2020

18. Role of DNA-detection–based tools for monitoring the soil-transmitted helminth treatment response in drug-efficacy trials

Author: European Commission, Fundación Ramón Areces, Ministerio de Economía y Competitividad (España), Gandasegui, Javier, Martínez Valladares, María, Grau-Pujol, B., Krolewiecki, A. J., Balaña-Fouce, Rafael, Gelaye, W., van Lieshout, L., Kepha, S., Mandomando, I., Muñoz, J., European Commission, Fundación Ramón Areces, Ministerio de Economía y Competitividad (España), Gandasegui, Javier, Martínez Valladares, María, Grau-Pujol, B., Krolewiecki, A. J., Balaña-Fouce, Rafael, Gelaye, W., van Lieshout, L., Kepha, S., Mandomando, I., and Muñoz, J.
Published: 2020

19. Colonization factors among enterotoxigenic Escherichia coli isolates from children with moderate-to-severe diarrhea and from matched controls in the Global Enteric Multicenter Study (GEMS)

Author: Torres, AG, Vidal, RM, Muhsen, K, Tennant, SM, Svennerholm, A-M, Sow, SO, Sur, D, Zaidi, AKM, Faruque, ASG, Saha, D, Adegbola, R, Hossain, MJ, Alonso, PL, Breiman, RF, Bassat, Q, Tamboura, B, Sanogo, D, Onwuchekwa, U, Manna, B, Ramamurthy, T, Kanungo, S, Ahmed, S, Qureshi, S, Quadri, F, Hossain, A, Das, SK, Antonio, M, Mandomando, I, Nhampossa, T, Acacio, S, Omore, R, Ochieng, JB, Oundo, JO, Mintz, ED, O'Reilly, CE, Berkeley, LY, Livio, S, Panchalingam, S, Nasrin, D, Farag, TH, Wu, Y, Sommerfelt, H, Robins-Browne, RM, Del Canto, F, Hazen, TH, Rasko, DA, Kotloff, KL, Nataro, JP, Levine, MM, Torres, AG, Vidal, RM, Muhsen, K, Tennant, SM, Svennerholm, A-M, Sow, SO, Sur, D, Zaidi, AKM, Faruque, ASG, Saha, D, Adegbola, R, Hossain, MJ, Alonso, PL, Breiman, RF, Bassat, Q, Tamboura, B, Sanogo, D, Onwuchekwa, U, Manna, B, Ramamurthy, T, Kanungo, S, Ahmed, S, Qureshi, S, Quadri, F, Hossain, A, Das, SK, Antonio, M, Mandomando, I, Nhampossa, T, Acacio, S, Omore, R, Ochieng, JB, Oundo, JO, Mintz, ED, O'Reilly, CE, Berkeley, LY, Livio, S, Panchalingam, S, Nasrin, D, Farag, TH, Wu, Y, Sommerfelt, H, Robins-Browne, RM, Del Canto, F, Hazen, TH, Rasko, DA, Kotloff, KL, Nataro, JP, and Levine, MM
Abstract: BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) encoding heat-stable enterotoxin (ST) alone or with heat-labile enterotoxin (LT) cause moderate-to-severe diarrhea (MSD) in developing country children. The Global Enteric Multicenter Study (GEMS) identified ETEC encoding ST among the top four enteropathogens. Since the GEMS objective was to provide evidence to guide development and implementation of enteric vaccines and other interventions to diminish diarrheal disease morbidity and mortality, we examined colonization factor (CF) prevalence among ETEC isolates from children age <5 years with MSD and from matched controls in four African and three Asian sites. We also assessed strength of association of specific CFs with MSD. METHODOLOGY/PRINCIPAL FINDINGS: MSD cases enrolled at healthcare facilities over three years and matched controls were tested in a standardized manner for many enteropathogens. To identify ETEC, three E. coli colonies per child were tested by polymerase chain reaction (PCR) to detect genes encoding LT, ST; confirmed ETEC were examined by PCR for major CFs (Colonization Factor Antigen I [CFA/I] or Coli Surface [CS] antigens CS1-CS6) and minor CFs (CS7, CS12, CS13, CS14, CS17, CS18, CS19, CS20, CS21, CS30). ETEC from 806 cases had a single toxin/CF profile in three tested strains per child. Major CFs, components of multiple ETEC vaccine candidates, were detected in 66.0% of LT/ST and ST-only cases and were associated with MSD versus matched controls by conditional logistic regression (p≤0.006); major CFs detected in only 25.0% of LT-only cases weren't associated with MSD. ETEC encoding exclusively CS14, identified among 19.9% of 291 ST-only and 1.5% of 259 LT/ST strains, were associated with MSD (p = 0.0011). No other minor CF exhibited prevalence ≥5% and significant association with MSD. CONCLUSIONS/SIGNIFICANCE: Major CF-based efficacious ETEC vaccines could potentially prevent up to 66% of pediatric MSD cases due to ST-encoding ETEC in develo
Published: 2019

20. The incidence, aetiology, and adverse clinical consequences of less severe diarrhoeal episodes among infants and children residing in low-income and middle-income countries: a 12-month case-control study as a follow-on to the Global Enteric Multicenter Study (GEMS)

Author: Kotloff, KL, Nasrin, D, Blackwelder, WC, Wu, Y, Farag, T, Panchalingham, S, Sow, SO, Sur, D, Zaidi, AKM, Faruque, ASG, Saha, D, Alonso, PL, Tamboura, B, Sanogo, D, Onwuchekwa, U, Manna, B, Ramamurthy, T, Kanungo, S, Ahmed, S, Qureshi, S, Quadri, F, Hossain, A, Das, SK, Antonio, M, Hossain, MJ, Mandomando, I, Acacio, S, Biswas, K, Tennant, SM, Verweij, JJ, Sommerfelt, H, Nataro, JP, Robins-Browne, RM, Levine, MM, Kotloff, KL, Nasrin, D, Blackwelder, WC, Wu, Y, Farag, T, Panchalingham, S, Sow, SO, Sur, D, Zaidi, AKM, Faruque, ASG, Saha, D, Alonso, PL, Tamboura, B, Sanogo, D, Onwuchekwa, U, Manna, B, Ramamurthy, T, Kanungo, S, Ahmed, S, Qureshi, S, Quadri, F, Hossain, A, Das, SK, Antonio, M, Hossain, MJ, Mandomando, I, Acacio, S, Biswas, K, Tennant, SM, Verweij, JJ, Sommerfelt, H, Nataro, JP, Robins-Browne, RM, and Levine, MM
Abstract: BACKGROUND: Diarrheal diseases remain a leading cause of illness and death among children younger than 5 years in low-income and middle-income countries. The Global Enteric Multicenter Study (GEMS) has described the incidence, aetiology, and sequelae of medically attended moderate-to-severe diarrhoea (MSD) among children aged 0-59 months residing in censused populations in sub-Saharan Africa and south Asia, where most child deaths occur. To further characterise this disease burden and guide interventions, we extended this study to include children with episodes of less-severe diarrhoea (LSD) seeking care at health centres serving six GEMS sites. METHODS: We report a 1-year, multisite, age-stratified, matched case-control study following on to the GEMS study. Six sites (Bamako, Mali; Manhiça, Mozambique; Basse, The Gambia; Mirzapur, Bangladesh; Kolkata, India; and Bin Qasim Town, Karachi, Pakistan) participated in this study. Children aged 0-59 months at each site who sought care at a sentinel hospital or health centre during a 12-month period were screened for diarrhoea. New (onset after ≥7 diarrhoea-free days) and acute (onset within the previous 7 days) episodes of diarrhoea in children who had sunken eyes, whose skin lost turgor, who received intravenous hydration, who had dysentery, or who were hospitalised were eligible for inclusion as MSD. The remaining new and acute diarrhoea episodes among children who sought care at the same health centres were considered LSD. We aimed to enrol the first eight or nine eligible children with MSD and LSD at each site during each fortnight in three age strata: infants (aged 0-11 months), toddlers (aged 12-23 months), and young children (aged 24-59 months). For each included case of MSD or LSD, we enrolled one to three community control children without diarrhoea during the previous 7 days. From patients and controls we collected clinical and epidemiological data, anthropometric measurements, and faecal samples to identify ent
Published: 2019

21. Infectious cause of death determination using minimally invasive autopsies in developing countries

Author: Martínez MJ, Massora S, Mandomando I, Ussene E, Jordao D, Lovane L, Munoz-Almagro C, Castillo P, Mayor A, Rodriguez C, Lopez-Villanueva M, Ismail MR, Carrilho C, Lorenzoni C, Lacerda MV, Bassat Q, Menéndez C, Ordi J, and Vila J
Published: 2016

22. Abstracts of the Eighth EDCTP Forum, 6-9 November 2016.

Author: Makanga, M, Beattie, P, Breugelmans, G, Nyirenda, T, Bockarie, M, Tanner, M, Volmink, J, Hankins, C, Walzl, G, Chegou, N, Malherbe, S, Hatherill, M, Scriba, TJ, Zak, DE, Barry, CE, Kaufmann, SHE, Noor, A, Strub-Wourgaft, N, Phillips, P, Munguambe, K, Ravinetto, R, Tinto, H, Diro, E, Mahendrahata, Y, Okebe, J, Rijal, S, Garcia, C, Sundar, S, Ndayisaba, G, Sopheak, T, Ngoduc, T, Van Loen, H, Jacobs, J, D'Alessandro, U, Boelaert, M, Buvé, A, Kamalo, P, Manda-Taylor, L, Rennie, S, Mokgatla, B, Bahati, Ijsselmuiden, C, Afolabi, M, Mcgrath, N, Kampmann, B, Imoukhuede, E, Alexander, N, Larson, H, Chandramohan, D, Bojang, K, Kasaro, MP, Muluka, B, Kaunda, K, Morse, J, Westfall, A, Kapata, N, Kruuner, A, Henostroza, G, Reid, S, Alabi, A, Foguim, F, Sankarganesh, J, Bruske, E, Mfoumbi, A, Mevyann, C, Adegnika, A, Lell, B, Kranzer, K, Kremsner, P, Grobusch, M, Sabiiti, W, Ntinginya, N, Kuchaka, D, Azam, K, Kampira, E, Mtafya, B, Bowness, R, Bhatt, N, Davies, G, Kibiki, G, Gillespie, S, Lejon, V, Ilboudo, H, Mumba, D, Camara, M, Kaba, D, Lumbala, C, Fèvre, E, Jamonneau, V, Bucheton, B, Büscher, P, Chisenga, C, Sinkala, E, Chilengi, R, Chitundu, H, Zyambo, Z, Wandeler, G, Vinikoor, M, Emilie, D, Camara, O, Mathurin, K, Guiguigbaza-Kossigan, D, Philippe, B, Regassa, F, Hassane, S, Bienvenu, SM, Fabrice, C, Ouédraogo, E, Kouakou, L, Owusu, M, Mensah, E, Enimil, A, Mutocheluh, M, Ndongo, FA, Tejiokem, MC, Texier, G, Penda, C, Ndiang, S, Ndongo, J-A, Guemkam, G, Sofeu, CL, Afumbom, K, Faye, A, Msellati, P, Warszawski, J, Vos, A, Devillé, W, Barth, R, Klipstein-Grobusch, K, Tempelman, H, Venter, F, Coutinho, R, Grobbee, D, Ssemwanga, D, Lyagoba, F, Magambo, B, Kapaata, A, Kirangwa, J, Nannyonjo, M, Nassolo, F, Nsubuga, R, Yebra, G, Brown, A, Kaleebu, P, Nylén, H, Habtewold, A, Makonnen, E, Yimer, G, Burhenne, J, Diczfalusy, U, Aklillu, E, Steele, D, Walker, R, Simuyandi, M, Beres, L, Bosomprah, S, Ansumana, R, Taitt, C, Lamin, JM, Jacobsen, KH, Mulvaney, SP, Leski, T, Bangura, U, Stenger, D, De Vries, S, Zinsou, FJ, Honkpehedji, J, Dejon, JC, Loembe, MM, Bache, B, Pakker, N, Van Leeuwen, R, Hounkpatin, AB, Yazdanbakhsh, M, Bethony, J, Hotez, P, Diemert, D, Bache, BE, Fernandes, JF, Obiang, RM, Kabwende, AL, Grobusch, MP, Krishna, S, Kremsner, PG, Todagbe, AS, Nambozi, M, Kabuya, J-B, Hachizovu, S, Mwakazanga, D, Kasongo, W, Buyze, J, Mulenga, M, Geertruyden, J-P, Gitaka, J, Chan, C, Kongere, J, Kagaya, W, Kaneko, A, Kabore, N, Barry, N, Kabre, Z, Werme, K, Fofana, A, Compaore, D, Nikiema, F, Some, F, Djimde, A, Zongo, I, Ouedraogo, B, Kone, A, Sagara, I, Björkman, A, Gil, JP, Nchinda, G, Bopda, A, Nji, N, Ambada, G, Ngu, L, Tchadji, J, Sake, C, Magagoum, S, Njambe, GD, Lisom, A, Park, CG, Tait, D, Sibusiso, H, Manda, O, Croucher, K, Van Der Westhuizen, A, Mshanga, I, Levin, J, Nanvubya, A, Kibengo, F, Jaoko, W, Pala, P, Perreau, M, Namuniina, A, Kitandwe, P, Tapia, G, Serwanga, J, Yates, N, Fast, P, Mayer, B, Montefiori, D, Tomaras, G, Robb, M, Lee, C, Wagner, R, Sanders, E, Kilembe, W, Kiwanuka, N, Gilmour, J, Kuipers, H, Vooij, D, Chinyenze, K, Priddy, F, Ding, S, Hanke, T, Pantaleo, G, Ngasala, B, Jovel, I, Malmberg, M, Mmbando, B, Premji, Z, Mårtensson, A, Mwaiswelo, R, Agbor, L, Apinjoh, T, Mwanza, S, Chileshe, J, Joshi, S, Malunga, P, Manyando, C, Laufer, M, Dara, A, Niangaly, A, Sinha, I, Brodin, D, Fofana, B, Dama, S, Dembele, D, Sidibe, B, Diallo, N, Thera, M, Wright, K, Gil, J, Doumbo, O, Baraka, V, Nabasumba, C, Francis, F, Lutumba, P, Mavoko, H, Alifrangis, M, Van Geertruyden, J-P, Sissoko, S, Sangaré, C, Toure, S, Sanogo, K, Diakite, H, Doumbia, D, Haidara, K, Julé, A, Ashurst, H, Merson, L, Olliaro, P, Marsh, V, Lang, T, Guérin, P, Awuondo, K, Njenga, D, Nyakarungu, E, Titus, P, Sutamihardja, A, Lowe, B, Ogutu, B, Billingsley, P, Soulama, I, Kaboré, M, Coulibaly, A, Ouattara, M, Sanon, S, Diarra, A, Bougouma, E, Ouedraogo, A, Sombie, B, Kargougou, D, Ouattara, D, Issa, N, Tiono, A, Sirima, S, Chaponda, M, Dabira, E, Dao, F, Dara, N, Coulibaly, M, Tolo, A, Maiga, H, Ouologuem, N, Niangaly, H, Botchway, F, Wilson, N, Dickinson-Copeland, CM, Adjei, AA, Wilson, M, Stiles, JK, Hamid, MA, Awad-Elgeid, M, Nasr, A, Netongo, P, Kamdem, S, Velavan, T, Lasry, E, Diarra, M, Bamadio, A, Traore, A, Coumare, S, Soma, B, Dicko, Y, Sangare, B, Tembely, A, Traore, D, Haidara, A, Dicko, A, Diawara, E, Beavogui, A, Camara, D, Sylla, M, Yattara, M, Sow, A, Camara, GC, Diallo, S, Mombo-Ngoma, G, Remppis, J, Sievers, M, Manego, RZ, Endamne, L, Hutchinson, D, Held, J, Supan, C, Salazar, CLO, Bonkian, LN, Nahum, A, Sié, A, Abdulla, S, Cantalloube, C, Djeriou, E, Bouyou-Akotet, M, Mordmüller, B, Siribie, M, Sirima, SB, Ouattara, SM, Coulibaly, S, Kabore, JM, Amidou, D, Tekete, M, Traore, O, Haefeli, W, Borrmann, S, Kaboré, N, Kabré, Z, Nikèma, F, Compaoré, D, Somé, F, Djimdé, A, Ouédraogo, J, Chalwe, V, Miller, J, Diakité, H, Greco, B, Spangenberg, T, Kourany-Lefoll, E, Oeuvray, C, Mulry, J, Tyagarajan, K, Magsaam, B, Barnes, K, Hodel, EM, Humphreys, G, Pace, C, Banda, CG, Denti, P, Allen, E, Lalloo, D, Mwapasa, V, Terlouw, A, Mwesigwa, J, Achan, J, Jawara, M, Ditanna, G, Worwui, A, Affara, M, Koukouikila-Koussounda, F, Kombo, M, Vouvoungui, C, Ntoumi, F, Etoka-Beka, MK, Deibert, J, Poulain, P, Kobawila, S, Gueye, NG, Seda, B, Kwambai, T, Jangu, P, Samuels, A, Kuile, FT, Kariuki, S, Barry, A, Bousema, T, Okech, B, Egwang, T, Corran, P, Riley, E, Ezennia, I, Ekwunife, O, Muleba, M, Stevenson, J, Mbata, K, Coetzee, M, Norris, D, Moneke-Anyanwoke, N, Momodou, J, Clarke, E, Scott, S, Tijani, A, Djimde, M, Vaillant, M, Samouda, H, Mensah, V, Roetynck, S, Kanteh, E, Bowyer, G, Ndaw, A, Oko, F, Bliss, C, Jagne, YJ, Cortese, R, Nicosia, A, Roberts, R, D'Alessio, F, Leroy, O, Faye, B, Cisse, B, Gerry, S, Viebig, N, Lawrie, A, Ewer, K, Hill, A, Nebie, I, Tiono, AB, Sanou, G, Konate, AT, Yaro, BJ, Sodiomon, S, Honkpehedji, Y, Agobe, JCD, Zinsou, F, Mengue, J, Richie, T, Hoffman, S, Nouatin, O, Ngoa, UA, Edoa, JR, Homoet, A, Engelhon, JE, Massinga-Louembe, M, Esen, M, Theisen, M, Sim, KL, Luty, AJ, Moutairou, K, Dinko, B, King, E, Targett, G, Sutherland, C, Likhovole, C, Ouma, C, Vulule, J, Musau, S, Khayumbi, J, Okumu, A, Murithi, W, Otu, J, Gehre, F, Zingue, D, Kudzawu, S, Forson, A, Mane, M, Rabna, P, Diarra, B, Kayede, S, Adebiyi, E, Kehinde, A, Onyejepu, N, Onubogu, C, Idigbe, E, Ba, A, Diallo, A, Mboup, S, Disse, K, Kadanga, G, Dagnra, Y, Baldeh, I, Corrah, T, De Jong, B, Antonio, M, Musanabaganwa, C, Musabyimana, JP, Karita, E, Diop, B, Nambajimana, A, Dushimiyimana, V, Karame, P, Russell, J, Ndoli, J, Hategekimana, T, Sendegeya, A, Condo, J, Binagwaho, A, Okonko, I, Okerentugba, P, Opaleye, O, Awujo, E, Frank-Peterside, N, Moyo, S, Kotokwe, K, Mohammed, T, Boleo, C, Mupfumi, L, Chishala, S, Gaseitsiwe, S, Tsalaile, L, Bussmann, H, Makhema, J, Baum, M, Marlink, R, Engelbretch, S, Essex, M, Novitsky, V, Saka, E, Kalipalire, Z, Bhairavabhotla, R, Midiani, D, Sherman, J, Mgode, G, Cox, C, Bwana, D, Mtui, L, Magesa, D, Kahwa, A, Mfinanga, G, Mulder, C, Borain, N, Petersen, L, Du Plessis, J, Theron, G, Holm-Hansen, C, Tekwu, EM, Sidze, LK, Assam, JPA, Eyangoh, S, Niemann, S, Beng, VP, Frank, M, Atiadeve, S, Hilmann, D, Awoniyi, D, Baumann, R, Kriel, B, Jacobs, R, Kidd, M, Loxton, A, Kaempfer, S, Singh, M, Mwanza, W, Milimo, D, Moyo, M, Kasese, N, Cheeba-Lengwe, M, Munkondya, S, Ayles, H, De Haas, P, Muyoyeta, M, Namuganga, AR, Kizza, HM, Mendy, A, Tientcheu, L, Ayorinde, A, Coker, E, Egere, U, Coussens, A, Naude, C, Chaplin, G, Noursadeghi, M, Martineau, A, Jablonski, N, Wilkinson, R, Ouedraogo, HG, Matteelli, A, Regazzi, M, Tarnagda, G, Villani, P, Sulis, G, Diagbouga, S, Roggi, A, Giorgetti, F, Kouanda, S, Bidias, A, Ndjonka, D, Olemba, C, Souleymanou, A, Mukonzo, J, Kuteesa, R, Ogwal-Okeng, J, Gustafsson, LL, Owen, J, Bassi, P, Gashau, W, Olaf, K, Dodoo, A, Okonkwo, P, Kanki, P, Maruapula, D, Seraise, B, Einkauf, K, Reilly, A, Rowley, C, Musonda, R, Framhein, A, Mpagama, S, Semvua, H, Maboko, L, Hoelscher, M, Heinrich, N, Mulenga, L, Kaayunga, C, Davies, M-A, Egger, M, Musukuma, K, Dambe, R, Usadi, B, Ngari, M, Thitiri, J, Mwalekwa, L, Fegan, G, Berkley, J, Nsagha, D, Munamunungu, V, Bolton, C, Siyunda, A, Shilimi, J, Bucciardini, R, Fragola, V, Abegaz, T, Lucattini, S, Halifom, A, Tadesse, E, Berhe, M, Pugliese, K, De Castro, P, Terlizzi, R, Fucili, L, Di Gregorio, M, Mirra, M, Zegeye, T, Binelli, A, Vella, S, Abraham, L, Godefay, H, Rakotoarivelo, R, Raberahona, M, Randriamampionona, N, Andriamihaja, R, Rasamoelina, T, Cornet, M, De Dieu Randria, MJ, Benet, T, Vanhems, P, Andrianarivelo, MR, Chirwa, U, Michelo, C, Hamoonga, R, Wandiga, S, Oduor, P, Agaya, J, Sharma, A, Cavanaugh, S, Cain, K, Mukisa, J, Mupere, E, Worodria, W, Ngom, JT, Koro, F, Godwe, C, Adande, C, Ateugieu, R, Onana, T, Ngono, A, Kamdem, Y, Ngo-Niobe, S, Etoa, F-X, Kanengoni, M, Ruzario, S, Ndebele, P, Shana, M, Tarumbiswa, F, Musesengwa, R, Gutsire, R, Fisher, K, Thyagarajan, B, Akanbi, O, Binuyo, M, Ssengooba, W, Respeito, D, Mambuque, E, Blanco, S, Mandomando, I, Cobelens, F, Garcia-Basteiro, A, Tamene, A, Topp, S, Mwamba, C, Padian, N, Sikazwe, I, Geng, E, Holmes, C, Sikombe, K, Hantuba, Czaicki, N, Simbeza, S, Somwe, P, Umulisa, M, Ilo, J, Kestelyn, E, Uwineza, M, Agaba, S, Delvaux, T, Wijgert, J, Gethi, D, Odeny, L, Tamandjou, C, Kaindjee-Tjituka, F, Brandt, L, Cotton, M, Nel, E, Preiser, W, Andersson, M, Adepoju, A, Magana, M, Etsetowaghan, A, Chilikwazi, M, Sutcliffe, C, Thuma, P, Sinywimaanzi, K, Matakala, H, Munachoonga, P, Moss, W, Masenza, IS, Geisenberger, O, Agrea, P, Rwegoshora, F, Mahiga, H, Olomi, W, Kroidl, A, Kayode, G, Amoakoh-Coleman, M, Ansah, E, Uthman, O, Fokam, J, Santoro, M-M, Musolo, C, Chimbiri, I, Chikwenga, G, Deula, R, Massari, R, Lungu, A, Perno, C-F, Ndzengue, G, Loveline, N, Lissom, A, Flaurent, T, Sosso, S, Essomba, C, Kpeli, G, Otchere, I, Lamelas, A, Buultjens, A, Bulach, D, Baines, S, Seemann, T, Giulieri, S, Nakobu, Z, Aboagye, S, Owusu-Mireku, E, Danso, E, Hauser, J, Hinic, V, Pluschke, G, Stinear, T, Yeboah-Manu, D, Elshayeb, A, Siddig, ME, Ahmed, AA, Hussien, AE, Kabwe, M, Tembo, J, Chilukutu, L, Chilufya, M, Ngulube, F, Lukwesa, C, Enne, V, Wexner, H, Mwananyanda, L, Hamer, D, Sinyangwe, S, Ahmed, Y, Klein, N, Maeurer, M, Zumla, A, Bates, M, Beyala, L, Etienne, G, Anthony, N, Benjamin, A, Ateudjieu, J, Chibwe, B, Ojok, D, Tarr, CA, Perez, GM, Omeonga, S, Kibungu, F, Meyer, A, Lansana, P, Mayor, A, Onyango, P, Van Loggerenberg, F, Furtado, T, Boggs, L, Segrt, A, Dochez, C, Burnett, R, Mphahlele, MJ, Miiro, G, Mbidde, E, Peshu, N, Kivaya, E, Ngowi, B, Kavishe, R, Maowia, M, Sandstrom, E, Ayuo, E, Mmbaga, B, Leisegang, C, Thorpe, M, Batchilly, E, N'Guessan, J-P, Kanteh, D, Søfteland, S, Sebitloane, M, Vwalika, B, Taylor, M, Galappaththi-Arachchige, H, Holmen, S, Gundersen, SG, Ndhlovu, P, Kjetland, EF, Kombe, F, Toohey, J, Pienaar, E, Kredo, T, Cham, PM, Abubakar, I, Dondeh, BL, Vischer, N, Pfeiffer, C, Burri, C, Musukwa, K, Zürcher, S, Mwandu, T, Bauer, S, Adriko, M, Mwaura, P, Omolloh, K, Jones, C, Malecela, M, Hamidu, BA, Jenner, TE, Asiedu, LJ, Osei-Atweneboana, M, Afeke, I, Addo, P, Newman, M, Durnez, L, Eddyani, M, Ammisah, N, Abas, M, Quartey, M, Ablordey, A, Akinwale, O, Adeneye, A, Ezeugwu, S, Olukosi, Y, Adewale, B, Sulyman, M, Mafe, M, Okwuzu, J, Gyang, P, Nwafor, T, Henry, U, Musa, B, Ujah, I, Agobé, JCD, Grau-Pujol, B, Sacoor, C, Nhabomba, A, Casellas, A, Quintó, L, Subirà, C, Giné, R, Valentín, A, Muñoz, J, Nikiema, M, Ky-Ba, A, Comapore, KAM, Sangare, L, Oluremi, A, Michel, M, Camara, Y, Sanneh, B, Cuamba, I, Gutiérrez, J, Lázaro, C, Mejia, R, Adedeji, A, Folorunsho, S, Demehin, P, Akinsanya, B, Cowley, G, Da Silva, ET, Nabicassa, M, De Barros, PDP, Blif, MM, Bailey, R, Last, A, Mahendradhata, Y, Gotuzzo, E, De Nys, K, Casteels, M, Nona, SK, Lumeka, K, Todagbe, A, Djima, MM, Ukpong, M, Sagay, A, Khamofu, H, Torpey, K, 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Endamne, L, Hutchinson, D, Held, J, Supan, C, Salazar, CLO, Bonkian, LN, Nahum, A, Sié, A, Abdulla, S, Cantalloube, C, Djeriou, E, Bouyou-Akotet, M, Mordmüller, B, Siribie, M, Sirima, SB, Ouattara, SM, Coulibaly, S, Kabore, JM, Amidou, D, Tekete, M, Traore, O, Haefeli, W, Borrmann, S, Kaboré, N, Kabré, Z, Nikèma, F, Compaoré, D, Somé, F, Djimdé, A, Ouédraogo, J, Chalwe, V, Miller, J, Diakité, H, Greco, B, Spangenberg, T, Kourany-Lefoll, E, Oeuvray, C, Mulry, J, Tyagarajan, K, Magsaam, B, Barnes, K, Hodel, EM, Humphreys, G, Pace, C, Banda, CG, Denti, P, Allen, E, Lalloo, D, Mwapasa, V, Terlouw, A, Mwesigwa, J, Achan, J, Jawara, M, Ditanna, G, Worwui, A, Affara, M, Koukouikila-Koussounda, F, Kombo, M, Vouvoungui, C, Ntoumi, F, Etoka-Beka, MK, Deibert, J, Poulain, P, Kobawila, S, Gueye, NG, Seda, B, Kwambai, T, Jangu, P, Samuels, A, Kuile, FT, Kariuki, S, Barry, A, Bousema, T, Okech, B, Egwang, T, Corran, P, Riley, E, Ezennia, I, Ekwunife, O, Muleba, M, Stevenson, J, Mbata, K, Coetzee, M, Norris, D, Moneke-Anyanwoke, N, Momodou, J, Clarke, E, Scott, S, Tijani, A, Djimde, M, Vaillant, M, Samouda, H, Mensah, V, Roetynck, S, Kanteh, E, Bowyer, G, Ndaw, A, Oko, F, Bliss, C, Jagne, YJ, Cortese, R, Nicosia, A, Roberts, R, D'Alessio, F, Leroy, O, Faye, B, Cisse, B, Gerry, S, Viebig, N, Lawrie, A, Ewer, K, Hill, A, Nebie, I, Tiono, AB, Sanou, G, Konate, AT, Yaro, BJ, Sodiomon, S, Honkpehedji, Y, Agobe, JCD, Zinsou, F, Mengue, J, Richie, T, Hoffman, S, Nouatin, O, Ngoa, UA, Edoa, JR, Homoet, A, Engelhon, JE, Massinga-Louembe, M, Esen, M, Theisen, M, Sim, KL, Luty, AJ, Moutairou, K, Dinko, B, King, E, Targett, G, Sutherland, C, Likhovole, C, Ouma, C, Vulule, J, Musau, S, Khayumbi, J, Okumu, A, Murithi, W, Otu, J, Gehre, F, Zingue, D, Kudzawu, S, Forson, A, Mane, M, Rabna, P, Diarra, B, Kayede, S, Adebiyi, E, Kehinde, A, Onyejepu, N, Onubogu, C, Idigbe, E, Ba, A, Diallo, A, Mboup, S, Disse, K, Kadanga, G, Dagnra, Y, Baldeh, I, Corrah, T, De Jong, B, Antonio, M, Musanabaganwa, C, Musabyimana, JP, Karita, E, Diop, B, Nambajimana, A, Dushimiyimana, V, Karame, P, Russell, J, Ndoli, J, Hategekimana, T, Sendegeya, A, Condo, J, Binagwaho, A, Okonko, I, Okerentugba, P, Opaleye, O, Awujo, E, Frank-Peterside, N, Moyo, S, Kotokwe, K, Mohammed, T, Boleo, C, Mupfumi, L, Chishala, S, Gaseitsiwe, S, Tsalaile, L, Bussmann, H, Makhema, J, Baum, M, Marlink, R, Engelbretch, S, Essex, M, Novitsky, V, Saka, E, Kalipalire, Z, Bhairavabhotla, R, Midiani, D, Sherman, J, Mgode, G, Cox, C, Bwana, D, Mtui, L, Magesa, D, Kahwa, A, Mfinanga, G, Mulder, C, Borain, N, Petersen, L, Du Plessis, J, Theron, G, Holm-Hansen, C, Tekwu, EM, Sidze, LK, Assam, JPA, Eyangoh, S, Niemann, S, Beng, VP, Frank, M, Atiadeve, S, Hilmann, D, Awoniyi, D, Baumann, R, Kriel, B, Jacobs, R, Kidd, M, Loxton, A, Kaempfer, S, Singh, M, Mwanza, W, Milimo, D, Moyo, M, Kasese, N, Cheeba-Lengwe, M, Munkondya, S, Ayles, H, De Haas, P, Muyoyeta, M, Namuganga, AR, Kizza, HM, Mendy, A, Tientcheu, L, Ayorinde, A, Coker, E, Egere, U, Coussens, A, Naude, C, Chaplin, G, Noursadeghi, M, Martineau, A, Jablonski, N, Wilkinson, R, Ouedraogo, HG, Matteelli, A, Regazzi, M, Tarnagda, G, Villani, P, Sulis, G, Diagbouga, S, Roggi, A, Giorgetti, F, Kouanda, S, Bidias, A, Ndjonka, D, Olemba, C, Souleymanou, A, Mukonzo, J, Kuteesa, R, Ogwal-Okeng, J, Gustafsson, LL, Owen, J, Bassi, P, Gashau, W, Olaf, K, Dodoo, A, Okonkwo, P, Kanki, P, Maruapula, D, Seraise, B, Einkauf, K, Reilly, A, Rowley, C, Musonda, R, Framhein, A, Mpagama, S, Semvua, H, Maboko, L, Hoelscher, M, Heinrich, N, Mulenga, L, Kaayunga, C, Davies, M-A, Egger, M, Musukuma, K, Dambe, R, Usadi, B, Ngari, M, Thitiri, J, Mwalekwa, L, Fegan, G, Berkley, J, Nsagha, D, Munamunungu, V, Bolton, C, Siyunda, A, Shilimi, J, Bucciardini, R, Fragola, V, Abegaz, T, Lucattini, S, Halifom, A, Tadesse, E, Berhe, M, Pugliese, K, De Castro, P, Terlizzi, R, Fucili, L, Di Gregorio, M, Mirra, M, Zegeye, T, Binelli, A, Vella, S, Abraham, L, Godefay, H, Rakotoarivelo, R, Raberahona, M, Randriamampionona, N, Andriamihaja, R, Rasamoelina, T, Cornet, M, De Dieu Randria, MJ, Benet, T, Vanhems, P, Andrianarivelo, MR, Chirwa, U, Michelo, C, Hamoonga, R, Wandiga, S, Oduor, P, Agaya, J, Sharma, A, Cavanaugh, S, Cain, K, Mukisa, J, Mupere, E, Worodria, W, Ngom, JT, Koro, F, Godwe, C, Adande, C, Ateugieu, R, Onana, T, Ngono, A, Kamdem, Y, Ngo-Niobe, S, Etoa, F-X, Kanengoni, M, Ruzario, S, Ndebele, P, Shana, M, Tarumbiswa, F, Musesengwa, R, Gutsire, R, Fisher, K, Thyagarajan, B, Akanbi, O, Binuyo, M, Ssengooba, W, Respeito, D, Mambuque, E, Blanco, S, Mandomando, I, Cobelens, F, Garcia-Basteiro, A, Tamene, A, Topp, S, Mwamba, C, Padian, N, Sikazwe, I, Geng, E, Holmes, C, Sikombe, K, Hantuba, Czaicki, N, Simbeza, S, Somwe, P, Umulisa, M, Ilo, J, Kestelyn, E, Uwineza, M, Agaba, S, Delvaux, T, Wijgert, J, Gethi, D, Odeny, L, Tamandjou, C, Kaindjee-Tjituka, F, Brandt, L, Cotton, M, Nel, E, Preiser, W, Andersson, M, Adepoju, A, Magana, M, Etsetowaghan, A, Chilikwazi, M, Sutcliffe, C, Thuma, P, Sinywimaanzi, K, Matakala, H, Munachoonga, P, Moss, W, Masenza, IS, Geisenberger, O, Agrea, P, Rwegoshora, F, Mahiga, H, Olomi, W, Kroidl, A, Kayode, G, Amoakoh-Coleman, M, Ansah, E, Uthman, O, Fokam, J, Santoro, M-M, Musolo, C, Chimbiri, I, Chikwenga, G, Deula, R, Massari, R, Lungu, A, Perno, C-F, Ndzengue, G, Loveline, N, Lissom, A, Flaurent, T, Sosso, S, Essomba, C, Kpeli, G, Otchere, I, Lamelas, A, Buultjens, A, Bulach, D, Baines, S, Seemann, T, Giulieri, S, Nakobu, Z, Aboagye, S, Owusu-Mireku, E, Danso, E, Hauser, J, Hinic, V, Pluschke, G, Stinear, T, Yeboah-Manu, D, Elshayeb, A, Siddig, ME, Ahmed, AA, Hussien, AE, Kabwe, M, Tembo, J, Chilukutu, L, Chilufya, M, Ngulube, F, Lukwesa, C, Enne, V, Wexner, H, Mwananyanda, L, Hamer, D, Sinyangwe, S, Ahmed, Y, Klein, N, Maeurer, M, Zumla, A, Bates, M, Beyala, L, Etienne, G, Anthony, N, Benjamin, A, Ateudjieu, J, Chibwe, B, Ojok, D, Tarr, CA, Perez, GM, Omeonga, S, Kibungu, F, Meyer, A, Lansana, P, Mayor, A, Onyango, P, Van Loggerenberg, F, Furtado, T, Boggs, L, Segrt, A, Dochez, C, Burnett, R, Mphahlele, MJ, Miiro, G, Mbidde, E, Peshu, N, Kivaya, E, Ngowi, B, Kavishe, R, Maowia, M, Sandstrom, E, Ayuo, E, Mmbaga, B, Leisegang, C, Thorpe, M, Batchilly, E, N'Guessan, J-P, Kanteh, D, Søfteland, S, Sebitloane, M, Vwalika, B, Taylor, M, Galappaththi-Arachchige, H, Holmen, S, Gundersen, SG, Ndhlovu, P, Kjetland, EF, Kombe, F, Toohey, J, Pienaar, E, Kredo, T, Cham, PM, Abubakar, I, Dondeh, BL, Vischer, N, Pfeiffer, C, Burri, C, Musukwa, K, Zürcher, S, Mwandu, T, Bauer, S, Adriko, M, Mwaura, P, Omolloh, K, Jones, C, Malecela, M, Hamidu, BA, Jenner, TE, Asiedu, LJ, Osei-Atweneboana, M, Afeke, I, Addo, P, Newman, M, Durnez, L, Eddyani, M, Ammisah, N, Abas, M, Quartey, M, Ablordey, A, Akinwale, O, Adeneye, A, Ezeugwu, S, Olukosi, Y, Adewale, B, Sulyman, M, Mafe, M, Okwuzu, J, Gyang, P, Nwafor, T, Henry, U, Musa, B, Ujah, I, Agobé, JCD, Grau-Pujol, B, Sacoor, C, Nhabomba, A, Casellas, A, Quintó, L, Subirà, C, Giné, R, Valentín, A, Muñoz, J, Nikiema, M, Ky-Ba, A, Comapore, KAM, Sangare, L, Oluremi, A, Michel, M, Camara, Y, Sanneh, B, Cuamba, I, Gutiérrez, J, Lázaro, C, Mejia, R, Adedeji, A, Folorunsho, S, Demehin, P, Akinsanya, B, Cowley, G, Da Silva, ET, Nabicassa, M, De Barros, PDP, Blif, MM, Bailey, R, Last, A, Mahendradhata, Y, Gotuzzo, E, De Nys, K, Casteels, M, Nona, SK, Lumeka, K, Todagbe, A, Djima, MM, Ukpong, M, Sagay, A, Khamofu, H, Torpey, K, Afiadigwe, E, Anenih, J, Ezechi, O, Nweneka, C, Idoko, J, Muhumuza, S, Katahoire, A, Nuwaha, F, Olsen, A, Okeyo, S, Omollo, R, Kimutai, R, Ochieng, M, Egondi, T, Moonga, C, Chileshe, C, Magwende, G, Anumudu, C, Onile, O, Oladele, V, Adebayo, A, Awobode, H, Oyeyemi, O, Odaibo, A, Kabuye, E, Lutalo, T, Njua-Yafi, C, Nkuo-Akenji, T, Anchang-Kimbi, J, Mugri, R, Chi, H, Tata, R, Njumkeng, C, Dodoo, D, Achidi, E, Fernandes, J, Bache, EB, Matakala, K, Searle, K, Greenman, M, and Rainwater-Lovett, K
Published: 2017

23. Genetic Variants in the IL-4/IL-13 Pathway Influence Measles Vaccine Responses and Vaccine Failure in Children from Mozambique.

Author: Clifford, H., Hayden, C., Khoo, S., Naniche, D., Mandomando, I., Zhang, Guicheng, Richmond, P., Le Souëf, P., Clifford, H., Hayden, C., Khoo, S., Naniche, D., Mandomando, I., Zhang, Guicheng, Richmond, P., and Le Souëf, P.
Abstract: Despite effective measles vaccines, measles still causes severe morbidity and mortality worldwide, particularly in developing countries. The Th2 pathway involving interleukin (IL)-4 and IL-13 cytokines, and their receptor IL-4Ra, play important roles in the Th1/Th2 balance and antibody production. A Th2 skewing of the cytokine milieu may affect vaccine responses. We investigated IL-4, IL-13, and IL-4Ra polymorphisms and their impact on measles IgG responses and measles vaccine failure, in two separate cohorts: 12-month-old Australian children immunized with measles-mumps-rubella vaccine (n?=?137) and a case/control cohort of children aged 6 months-14 years from Mozambique, Africa (n?=?89), some of whom were vaccinated, but still contracted measles (vaccine failure). We found that IL-4Ra haplotypes for Val75Ile, Ser503Pro, and Arg576Gln were associated with measles IgG in Mozambican children (p?=?0.016 and p?=?0.032 for Val.Pro.Arg and Val.Ser.Arg, respectively), but not Australian children. IL-4Ra 503Pro was more prevalent in Mozambique vaccine failure cases compared with controls (p?=?0.008). We showed that the impact of Th2 genes on measles vaccine responses differs between ethnicities and IL-4Ra polymorphisms may work in combination to affect measles antibody responses and vaccine failure in Mozambican children. Studies in this area are particularly important in developing countries like Mozambique where measles is still a major health issue.
Published: 2017

24. The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS)

Author: Kosek, M, Sow, SO, Muhsen, K, Nasrin, D, Blackwelder, WC, Wu, Y, Farag, TH, Panchalingam, S, Sur, D, Zaidi, AKM, Faruque, ASG, Saha, D, Adegbola, R, Alonso, PL, Breiman, RF, Bassat, Q, Tamboura, B, Sanogo, D, Onwuchekwa, U, Manna, B, Ramamurthy, T, Kanungo, S, Ahmed, S, Qureshi, S, Quadri, F, Hossain, A, Das, SK, Antonio, M, Hossain, MJ, Mandomando, I, Nhampossa, T, Acacio, S, Omore, R, Oundo, JO, Ochieng, JB, Mintz, ED, O'Reilly, CE, Berkeley, LY, Livio, S, Tennant, SM, Sommerfelt, H, Nataro, JP, Ziv-Baran, T, Robins-Browne, RM, Mishcherkin, V, Zhang, J, Liu, J, Houpt, ER, Kotloff, KL, Levine, MM, Kosek, M, Sow, SO, Muhsen, K, Nasrin, D, Blackwelder, WC, Wu, Y, Farag, TH, Panchalingam, S, Sur, D, Zaidi, AKM, Faruque, ASG, Saha, D, Adegbola, R, Alonso, PL, Breiman, RF, Bassat, Q, Tamboura, B, Sanogo, D, Onwuchekwa, U, Manna, B, Ramamurthy, T, Kanungo, S, Ahmed, S, Qureshi, S, Quadri, F, Hossain, A, Das, SK, Antonio, M, Hossain, MJ, Mandomando, I, Nhampossa, T, Acacio, S, Omore, R, Oundo, JO, Ochieng, JB, Mintz, ED, O'Reilly, CE, Berkeley, LY, Livio, S, Tennant, SM, Sommerfelt, H, Nataro, JP, Ziv-Baran, T, Robins-Browne, RM, Mishcherkin, V, Zhang, J, Liu, J, Houpt, ER, Kotloff, KL, and Levine, MM
Abstract: BACKGROUND: The importance of Cryptosporidium as a pediatric enteropathogen in developing countries is recognized. METHODS: Data from the Global Enteric Multicenter Study (GEMS), a 3-year, 7-site, case-control study of moderate-to-severe diarrhea (MSD) and GEMS-1A (1-year study of MSD and less-severe diarrhea [LSD]) were analyzed. Stools from 12,110 MSD and 3,174 LSD cases among children aged <60 months and from 21,527 randomly-selected controls matched by age, sex and community were immunoassay-tested for Cryptosporidium. Species of a subset of Cryptosporidium-positive specimens were identified by PCR; GP60 sequencing identified anthroponotic C. parvum. Combined annual Cryptosporidium-attributable diarrhea incidences among children aged <24 months for African and Asian GEMS sites were extrapolated to sub-Saharan Africa and South Asian regions to estimate region-wide MSD and LSD burdens. Attributable and excess mortality due to Cryptosporidium diarrhea were estimated. FINDINGS: Cryptosporidium was significantly associated with MSD and LSD below age 24 months. Among Cryptosporidium-positive MSD cases, C. hominis was detected in 77.8% (95% CI, 73.0%-81.9%) and C. parvum in 9.9% (95% CI, 7.1%-13.6%); 92% of C. parvum tested were anthroponotic genotypes. Annual Cryptosporidium-attributable MSD incidence was 3.48 (95% CI, 2.27-4.67) and 3.18 (95% CI, 1.85-4.52) per 100 child-years in African and Asian infants, respectively, and 1.41 (95% CI, 0.73-2.08) and 1.36 (95% CI, 0.66-2.05) per 100 child-years in toddlers. Corresponding Cryptosporidium-attributable LSD incidences per 100 child-years were 2.52 (95% CI, 0.33-5.01) and 4.88 (95% CI, 0.82-8.92) in infants and 4.04 (95% CI, 0.56-7.51) and 4.71 (95% CI, 0.24-9.18) in toddlers. We estimate 2.9 and 4.7 million Cryptosporidium-attributable cases annually in children aged <24 months in the sub-Saharan Africa and India/Pakistan/Bangladesh/Nepal/Afghanistan regions, respectively, and ~202,000 Cryptosporidium-attributable deat
Published: 2016

25. Structural insight into host recognition and biofilm formation by aggregative adherence fimbriae of enteroaggregative Esherichia coli

Author: Matthews, S.J., primary, Yang, Y., additional, Berry, A.A., additional, Pakharukova, N., additional, Garnett, J.A., additional, Lee, W., additional, Cota, E., additional, Liu, B., additional, Roy, S., additional, Tuittila, M., additional, Marchant, J., additional, Inman, K.G., additional, Ruiz-Perez, F., additional, Mandomando, I., additional, Nataro, J.P., additional, and Zavialov, A.V., additional
Published: 2014
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26. Shigella Isolates From the Global Enteric Multicenter Study Inform Vaccine Development

Author: Livio, S., primary, Strockbine, N. A., additional, Panchalingam, S., additional, Tennant, S. M., additional, Barry, E. M., additional, Marohn, M. E., additional, Antonio, M., additional, Hossain, A., additional, Mandomando, I., additional, Ochieng, J. B., additional, Oundo, J. O., additional, Qureshi, S., additional, Ramamurthy, T., additional, Tamboura, B., additional, Adegbola, R. A., additional, Hossain, M. J., additional, Saha, D., additional, Sen, S., additional, Faruque, A. S. G., additional, Alonso, P. L., additional, Breiman, R. F., additional, Zaidi, A. K. M., additional, Sur, D., additional, Sow, S. O., additional, Berkeley, L. Y., additional, O'Reilly, C. E., additional, Mintz, E. D., additional, Biswas, K., additional, Cohen, D., additional, Farag, T. H., additional, Nasrin, D., additional, Wu, Y., additional, Blackwelder, W. C., additional, Kotloff, K. L., additional, Nataro, J. P., additional, and Levine, M. M., additional
Published: 2014
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27. Study of ceftriaxone-resistant Klebsiella spp. clinical isolates from a rural hospital in Mozambique

Author: Pons, M.J., primary, Alonso, P.L., additional, Vila, J., additional, Mandomando, I., additional, Sigauque, B., additional, Fraile, O., additional, Vubil, D., additional, Palma, N., additional, Guiral, E., additional, and Ruiz, J., additional
Published: 2014
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28. An overview of invasive non-typhoidalSalmonella(iNTS) epidemiology

Author: Levine, M., primary, Tapia, M., additional, Bornstein, K., additional, Tennant, S., additional, Sow, S., additional, Mandomando, I., additional, and MacLennan, C., additional
Published: 2014
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29. Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study

Author: Kotloff, KL, Nataro, JP, Blackwelder, WC, Nasrin, D, Farag, TH, Panchalingam, S, Wu, Y, Sow, SO, Sur, D, Breiman, RF, Faruque, ASG, Zaidi, AKM, Saha, D, Alonso, PL, Tamboura, B, Sanogo, D, Onwuchekwa, U, Manna, B, Ramamurthy, T, Kanungo, S, Ochieng, JB, Omore, R, Oundo, JO, Hossain, A, Das, SK, Ahmed, S, Qureshi, S, Quadri, F, Adegbola, RA, Antonio, M, Hossain, MJ, Akinsola, A, Mandomando, I, Nhampossa, T, Acacio, S, Biswas, K, O'Reilly, CE, Mintz, ED, Berkeley, LY, Muhsen, K, Sommerfelt, H, Robins-Browne, RM, Levine, MM, Kotloff, KL, Nataro, JP, Blackwelder, WC, Nasrin, D, Farag, TH, Panchalingam, S, Wu, Y, Sow, SO, Sur, D, Breiman, RF, Faruque, ASG, Zaidi, AKM, Saha, D, Alonso, PL, Tamboura, B, Sanogo, D, Onwuchekwa, U, Manna, B, Ramamurthy, T, Kanungo, S, Ochieng, JB, Omore, R, Oundo, JO, Hossain, A, Das, SK, Ahmed, S, Qureshi, S, Quadri, F, Adegbola, RA, Antonio, M, Hossain, MJ, Akinsola, A, Mandomando, I, Nhampossa, T, Acacio, S, Biswas, K, O'Reilly, CE, Mintz, ED, Berkeley, LY, Muhsen, K, Sommerfelt, H, Robins-Browne, RM, and Levine, MM
Abstract: BACKGROUND: Diarrhoeal diseases cause illness and death among children younger than 5 years in low-income countries. We designed the Global Enteric Multicenter Study (GEMS) to identify the aetiology and population-based burden of paediatric diarrhoeal disease in sub-Saharan Africa and south Asia. METHODS: The GEMS is a 3-year, prospective, age-stratified, matched case-control study of moderate-to-severe diarrhoea in children aged 0-59 months residing in censused populations at four sites in Africa and three in Asia. We recruited children with moderate-to-severe diarrhoea seeking care at health centres along with one to three randomly selected matched community control children without diarrhoea. From patients with moderate-to-severe diarrhoea and controls, we obtained clinical and epidemiological data, anthropometric measurements, and a faecal sample to identify enteropathogens at enrolment; one follow-up home visit was made about 60 days later to ascertain vital status, clinical outcome, and interval growth. FINDINGS: We enrolled 9439 children with moderate-to-severe diarrhoea and 13,129 control children without diarrhoea. By analysing adjusted population attributable fractions, most attributable cases of moderate-to-severe diarrhoea were due to four pathogens: rotavirus, Cryptosporidium, enterotoxigenic Escherichia coli producing heat-stable toxin (ST-ETEC; with or without co-expression of heat-labile enterotoxin), and Shigella. Other pathogens were important in selected sites (eg, Aeromonas, Vibrio cholerae O1, Campylobacter jejuni). Odds of dying during follow-up were 8·5-fold higher in patients with moderate-to-severe diarrhoea than in controls (odd ratio 8·5, 95% CI 5·8-12·5, p<0·0001); most deaths (167 [87·9%]) occurred during the first 2 years of life. Pathogens associated with increased risk of case death were ST-ETEC (hazard ratio [HR] 1·9; 0·99-3·5) and typical enteropathogenic E coli (HR 2·6; 1·6-4·1) in infants aged 0-11 months, and Cryptosporidium (HR
Published: 2013

30. Impact of CD14 Promoter Variants on Measles Vaccine Responses and Vaccine Failure in Children from Australia and Mozambique

Author: Clifford, H., Hayden, C., Khoo, S., Daniche, D., Mandomando, I., Zhang, Guicheng, Richmond, P., Le Souef, P., Clifford, H., Hayden, C., Khoo, S., Daniche, D., Mandomando, I., Zhang, Guicheng, Richmond, P., and Le Souef, P.
Published: 2013

31. Diagnostic Microbiologic Methods in the GEMS-1 Case/Control Study

Author: Panchalingam, S, Antonio, M, Hossain, A, Mandomando, I, Ochieng, B, Oundo, J, Ramamurthy, T, Tamboura, B, Zaidi, AKM, Petri, W, Houpt, E, Murray, P, Prado, V, Vidal, R, Steele, D, Strockbine, N, Sansonetti, P, Glass, RI, Robins-Browne, RM, Tauschek, M, Svennerholm, A-M, Kotloff, K, Levine, MM, Nataro, JP, Panchalingam, S, Antonio, M, Hossain, A, Mandomando, I, Ochieng, B, Oundo, J, Ramamurthy, T, Tamboura, B, Zaidi, AKM, Petri, W, Houpt, E, Murray, P, Prado, V, Vidal, R, Steele, D, Strockbine, N, Sansonetti, P, Glass, RI, Robins-Browne, RM, Tauschek, M, Svennerholm, A-M, Kotloff, K, Levine, MM, and Nataro, JP
Abstract: To understand the etiology of moderate-to-severe diarrhea among children in high mortality areas of sub-Saharan Africa and South Asia, we performed a comprehensive case/control study of children aged <5 years at 7 sites. Each site employed an identical case/control study design and each utilized a uniform comprehensive set of microbiological assays to identify the likely bacterial, viral and protozoal etiologies. The selected assays effected a balanced consideration of cost, robustness and performance, and all assays were performed at the study sites. Identification of bacterial pathogens employed streamlined conventional bacteriologic biochemical and serological algorithms. Diarrheagenic Escherichia coli were identified by application of a multiplex polymerase chain reaction assay for enterotoxigenic, enteroaggregative, and enteropathogenic E. coli. Rotavirus, adenovirus, Entamoeba histolytica, Giardia enterica, and Cryptosporidium species were detected by commercially available enzyme immunoassays on stool samples. Samples positive for adenovirus were further evaluated for adenovirus serotypes 40 and 41. We developed a novel multiplex assay to detect norovirus (types 1 and 2), astrovirus, and sapovirus. The portfolio of diagnostic assays used in the GEMS study can be broadly applied in developing countries seeking robust cost-effective methods for enteric pathogen detection.
Published: 2012

32. Intracontinental spread of human invasive Salmonella Typhimurium pathovariants in sub-Saharan Africa

Author: Okoro, CK, Kingsley, RA, Connor, TR, Harris, SR, Parry, CM, Al-Mashhadani, MN, Kariuki, S, Msefula, CL, Gordon, MA, de Pinna, E, Wain, J, Heyderman, RS, Obaro, S, Alonso, PL, Mandomando, I, MacLennan, CA, Tapia, MD, Levine, MM, Tennant, SM, Parkhill, J, Dougan, G, Okoro, CK, Kingsley, RA, Connor, TR, Harris, SR, Parry, CM, Al-Mashhadani, MN, Kariuki, S, Msefula, CL, Gordon, MA, de Pinna, E, Wain, J, Heyderman, RS, Obaro, S, Alonso, PL, Mandomando, I, MacLennan, CA, Tapia, MD, Levine, MM, Tennant, SM, Parkhill, J, and Dougan, G
Abstract: A highly invasive form of non-typhoidal Salmonella (iNTS) disease has recently been documented in many countries in sub-Saharan Africa. The most common Salmonella enterica serovar causing this disease is Typhimurium (Salmonella Typhimurium). We applied whole-genome sequence-based phylogenetic methods to define the population structure of sub-Saharan African invasive Salmonella Typhimurium isolates and compared these to global Salmonella Typhimurium populations. Notably, the vast majority of sub-Saharan invasive Salmonella Typhimurium isolates fell within two closely related, highly clustered phylogenetic lineages that we estimate emerged independently ∼52 and ∼35 years ago in close temporal association with the current HIV pandemic. Clonal replacement of isolates from lineage I by those from lineage II was potentially influenced by the use of chloramphenicol for the treatment of iNTS disease. Our analysis suggests that iNTS disease is in part an epidemic in sub-Saharan Africa caused by highly related Salmonella Typhimurium lineages that may have occupied new niches associated with a compromised human population and antibiotic treatment.
Published: 2012

33. Polymorphisms in key innate immune genes and their effects on measles vaccine responses and vaccine failure in children from Mozambique

Author: Clifford, H., Hayden, C., Khoo, S., Naniche, D., Mandomando, I., Zhang, Guicheng, Richmond, P., Le Souëf, P., Clifford, H., Hayden, C., Khoo, S., Naniche, D., Mandomando, I., Zhang, Guicheng, Richmond, P., and Le Souëf, P.
Abstract: Despite an effective vaccine, measles remains a major health problem globally, particularly in developing countries. More than 30% of children show primary vaccine failure and therefore remain vulnerable to measles. Genetic variation in key innate pathogen recognition receptors, such as the measles cell entry receptors CD46 and SLAM, measles attachment receptor DC-SIGN, the antiviral toll-like receptors (TLR)3, TLR7 and TLR8, and the cytosolic antiviral receptor RIG-I, may significantly affect measles IgG antibody responses. Measles is still highly prevalent in developing countries such as those in Africa however there is no previous data on the effect of these innate immune genes in a resident African population. Polymorphisms (n= 29) in the candidate genes were genotyped in a cohort of vaccinated children (n= 238) aged 6 months-14 years from Mozambique, Africa who either had vaccine failure and contracted measles (cases; n= 66) or controls (n= 172). Contrasting previous associations with measles responses in Caucasians and/or strong evidence for candidacy, we found little indication that these key innate immune genes affect measles IgG responses in our cohort of Mozambican children. We did however identify that CD46 and TLR8 variants may be involved in the occurrence of measles vaccine failure. This study highlights the importance of genetic studies in resident, non-Caucasian populations, from areas where determining the factors that may affect measles control is of a high priority. © 2012 Elsevier Ltd.
Published: 2012

34. Profile: Manhica Health Research Centre (Manhica HDSS)

Author: Sacoor, C., primary, Nhacolo, A., additional, Nhalungo, D., additional, Aponte, J. J., additional, Bassat, Q., additional, Augusto, O., additional, Mandomando, I., additional, Sacarlal, J., additional, Lauchande, N., additional, Sigauque, B., additional, Alonso, P., additional, and Macete, E., additional
Published: 2013
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35. HIV and Placental Infection Modulate the Appearance of Drug-Resistant Plasmodium falciparum in Pregnant Women who Receive Intermittent Preventive Treatment

Author: Menendez, C., primary, Serra-Casas, E., additional, Scahill, M. D., additional, Sanz, S., additional, Nhabomba, A., additional, Bardaji, A., additional, Sigauque, B., additional, Cistero, P., additional, Mandomando, I., additional, Dobano, C., additional, Alonso, P. L., additional, and Mayor, A., additional
Published: 2011
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36. Serotype-specific pneumococcal disease may be influenced by mannose-binding lectin deficiency

Author: Valles, X., primary, Roca, A., additional, Lozano, F., additional, Morais, L., additional, Suarez, B., additional, Casals, F., additional, Mandomando, I., additional, Sigauque, B., additional, Nhalungo, D., additional, Esquinas, C., additional, Quinto, L., additional, Alonso, P. L., additional, and Torres, A., additional
Published: 2010
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37. Genetic and structural analysis ofMBL2andMASP2polymorphisms in south-eastern African children

Author: Vallès, X., primary, Sarrias, M.-R., additional, Casals, F., additional, Farnós, M., additional, Piñer, R., additional, Suárez, B., additional, Morais, L., additional, Mandomando, I., additional, Sigaúque, B., additional, Roca, A., additional, Alonso, P. L., additional, Torres, A., additional, Thielens, N. M., additional, and Lozano, F., additional
Published: 2009
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38. P511 Salmonella enterica serotype Typhimurium DT104 as a cause of infantile bacteraemia in Southern Mozambique

Author: Ruiz, J., primary, Mandomando, I., additional, Macete, E., additional, Puyol, L., additional, Echeita, A., additional, and Alonso, P., additional
Published: 2007
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39. Safety and immunogenicity of the RTS,S/AS02A candidate malaria vaccine in children aged 1?4 in Mozambique

Author: Macete, E., primary, Aponte, J. J., additional, Guinovart, C., additional, Sacarlal, J., additional, Ofori-Anyinam, O., additional, Mandomando, I., additional, Espasa, M., additional, Bevilacqua, C., additional, Leach, A., additional, Dubois, M. C., additional, Heppner, D. G., additional, Tello, L., additional, Milman, J., additional, Cohen, J., additional, Dubovsky, F., additional, Tornieporth, N., additional, Thompson, R., additional, and Alonso, P. L., additional
Published: 2006
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40. Pharmacokinetic and Pharmacodynamic Characteristics of a New Pediatric Formulation of Artemether-Lumefantrine in African Children with Uncomplicated Plasmodium falciparum Malaria

Author: Aa, Djimdé, Tekete M, Abdulla S, Lyimo J, Quique Bassat, Mandomando I, Lefèvre G, and Borrmann S

41. Short report: Detection of Salmonella enterica serotype typhimurium DT104 in mozambique

Author: Ruiz, J., Herrera-Leon, S., Mandomando, I., Macete, E., Laura Puyol, Echeita, A., and Alonso, P. L.

42. Safety of the RTS,S/AS02D candidate malaria vaccine in infants living in a highly endemic area of Mozambique: a double blind randomised controlled phase I/IIb trial.

Author: Aponte JJ, Aide P, Renom M, Mandomando I, Bassat Q, Sacarlal J, Manaca MN, Lafuente S, Barbosa A, Leach A, Lievens M, Vekemans J, Sigauque B, Dubois MC, Demoitié MA, Sillman M, Savarese B, McNeil JG, Macete E, and Ballou WR
Abstract: BACKGROUND: Malaria remains a leading global health problem that requires the improved use of existing interventions and the accelerated development of new control methods. We aimed to assess the safety, immunogenicity, and initial efficacy of the malaria vaccine RTS,S/AS02D in infants in Africa. METHODS: We did a phase I/IIb double-blind randomised trial of 214 infants in Mozambique. Infants were randomly assigned to receive three doses either of RTS,S/AS02D or the hepatitis B vaccine Engerix-B at ages 10 weeks, 14 weeks, and 18 weeks of age, as well as routine immunisation vaccines given at 8, 12, and 16 weeks of age. The primary endpoint was safety of the RTS,S/AS02D during the first 6 months of the study, and analysis was by intention to treat. Secondary endpoints included immunogenicity and analysis of new Plasmodium falciparum infections during a 3-month follow up after the third dose. Time to new infections in the per-protocol cohort were compared between groups using Cox regression models. This study is registered with ClinicalTrials.gov, number NCT00197028. FINDINGS: There were 17 children (15.9%; 95% CI 9.5-24.2) with serious adverse events in each group. In the follow-up which ended on March 6, 2007, there were 31 serious adverse events in the RTS,S/AS02D group and 30 serious adverse events in the Engerix-B group, none of which were reported as related to vaccination. There were four deaths during this same follow-up period; all of them after the active detection of infection period had finished at study month 6 (two in RTSS/AS02D group and two in the Engerix-B group). RTS,S/AS02D induced high titres of anti-circumsporozoite antibodies. 68 first or only P falciparum infections were documented: 22 in the RTS,S/AS02D group and 46 in the control group. The adjusted vaccine efficacy was 65.9% (95% CI 42.6-79.8%, p<0.0001). INTERPRETATION: The RTS,S/AS02D malaria vaccine was safe, well tolerated, and immunogenic in young infants. These findings set the stage for expanded phase III efficacy studies to confirm vaccine efficacy against clinical malaria disease. [ABSTRACT FROM AUTHOR]
Published: 2007
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43. Duration of protection with RTS,S/AS02A malaria vaccine in prevention of Plasmodium falciparum disease in Mozambican children: single-blind extended follow-up of a randomised controlled trial.

Author: Alonso PL, Sacarlal J, Aponte JJ, Leach A, Macete E, Aide P, Sigauque B, Milman J, Mandomando I, Bassat Q, Guinovart C, Espasa M, Corachan S, Lievens M, Navia MM, Dubois MC, Menendez C, Dubovsky F, Cohen J, and Thompson R
Published: 2005
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44. Efficacy of the RTS,S/AS02A vaccine against Plasmodium falciparum infection and disease in young African children: randomised controlled trial.

Author: Alonso PL, Sacarlal J, Aponte JJ, Leach A, Macete E, Milman J, Mandomando I, Spiessens B, Guinovart C, Espasa M, Bassat Q, Aide P, Ofori-Anyinam O, Navia MM, Corachan S, Ceuppens M, Dubois MC, Demoitié MA, Dubovsky F, and Menéndez C
Published: 2004
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45. Consequences of Mycobacterium tuberculosis genetic diversity in the context of HIV co-infection for laboratory diagnosis of tuberculosis in Africa

Author: Ssengooba, Willy, Cobelens, F.G.J., Vila, J., van Leth, F.C.M., Mandomando, I., de Jong, B.C.H., Faculteit der Geneeskunde, Cobelens, Franciscus G. J., van Leth, F. C. M., de Jong, B. C. H., Infectious diseases, APH - Methodology, APH - Global Health, Global Health, and AII - Infectious diseases
Abstract: Willy Ssengooba’s thesis evaluates the consequences of the genetic diversity of Mycobacterium tuberculosis, the causative agent of tuberculosis, for diagnosis of this disease tuberculosis in Africa, often in HIV co-infected patients. It addresses three main sub-themes around M. tuberculosis genetic diversity; laboratory diagnosis, clinical presentation of tuberculosis disease and resistance to anti-tuberculosis drugs. For the first two sub-themes, he looked at how to best use molecular assays in practice given the various disease presentations especially in HIV-positive patients who often have bloodstream infections (mycobacteremia). He further looked at additional attributes of molecular assays and the extent to which genetic diversity of M. tuberculosis may influence the reliability and interpretation of results of molecular assays. Under the drug resistance theme, he evaluated the extent of variations and risk factors of drug-resistant tuberculosis in sub-Saharan Africa in a systematic review and meta-analysis. Furthermore, he determined the diversity of drug resistance-conferring mutations that could be picked up by molecular tests (existing or under development) in a country with a drug-resistant tuberculosis epidemic that is typical for the African region. Lastly he investigated to what extent this diversity is affected by HIV-coinfection given the fitness cost differences between different resistance-conferring mutations.
Published: 2017

46. Structural basis of aggregative adherence fimbriae II interactions with sialic acid, mucin, and human intestinal cells.

Author: Hagin LW, Mandomando I, Ruiz-Perez F, Wright NT, and Gonyar LA
Abstract: Enteroaggregative Escherichia coli (EAEC) is a common cause of diarrhea worldwide and is associated with growth faltering in developing countries. EAEC are defined by a characteristic adherence pattern mediated by the aggregative adherence fimbriae (AAFs). Despite the critical role of AAF in the definition of the EAEC pathotype, it is not known what host molecules mediate adherence and EAEC pathogenesis during infection of the human gastrointestinal tract. Multiple receptor candidates have been proposed based on in vitro experimentation. We propose that AAFs interact with multiple receptors during colonization of the human gastrointestinal mucosa, and we hypothesize that structural features of the AafA protein (the major subunit of AAF variant II produced by EAEC strain 042) promote these diverse interactions. In this study, we utilize a panel of AafA variants encoding single amino acid substitutions to understand the role of individual residues in biofilm formation as well as adherence to mucin, fibronectin, and human intestinal cells. We identify both charged and uncharged residues that participate in these interactions, and these residues cluster in two regions of the protein that may define a binding pocket at the junction of polymerized subunits. Although both bovine submaxillary mucin and human fibronectin are sialylated molecules, adherence to mucin is diminished by the removal of sialic acid residues while adherence to fibronectin is not, suggesting that the mechanisms of adherence to these molecules are distinct. Overall, our data provide insight into the structural features that determine AAF/II binding to mucin, sialic acid, and human intestinal cells.
Published: 2025
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47. A decade of rotavirus vaccination in the World Health Organization African Region: An in-depth analysis of vaccine coverage from 2012 to 2023.

Author: Mwenda JM, Mandomando I, Worwui AK, Gacic-Dobo M, Katsande R, Bwaka AM, Messa A Jr, Kiulia NM, Massora S, Garrine M, Weldegebriel GG, Biey JN, Mitula P, Wiysonge CS, Paluku G, Mumba M, Wanyoike SW, and Impouma B
Subjects: Humans, Africa epidemiology, Infant, Vaccination statistics & numerical data, Vaccination trends, Child, Preschool, COVID-19 prevention & control, COVID-19 epidemiology, Rotavirus immunology, Rotavirus Vaccines administration & dosage, Rotavirus Vaccines immunology, World Health Organization, Rotavirus Infections prevention & control, Rotavirus Infections epidemiology, Vaccination Coverage statistics & numerical data, Immunization Programs
Abstract: Background: Significant progress has been achieved in the introduction of rotavirus vaccines in the World Health Organization, African Region (WHO/AFR), with only 19% (9/47) of the countries yet to introduce the vaccines. Despite this achievement, a considerable number of eligible children in Africa still lack access to these lifesaving rotavirus vaccines., Methodology: We performed in-depth data exploration and analysis on the WHO/UNICEF rotavirus vaccine uptake estimates of vaccine coverage to document progress and estimated the number of children missing vaccination through under- or un-vaccination between 2012 and 2023., Results: Thirty-eight countries have introduced the vaccine in the national immunization programs and the vaccine coverage rates have increased from 5% to 61% between 2012 and 2023 in the WHO/AFR, compared to 11% to 55% at the global level. Coverage by sub-regions ranged from 48% in Central African countries to 73% in the Southeast sub-region in 2023. Vaccine coverage has been increasing every year, yet some countries reported a significant drop during the COVID-19 pandemic (2020-2022) compared to the pre-pandemic (2019_or earlier) period. For instance, in Senegal, coverage declined from 94% to 70%; Namibia, 90% to 55%; Republic of Congo, 71% to 23 %; for 2019 and 2022, respectively. Four countries experienced a significant decline between 2021 and 2022. For instance, Botswana (85% to 65%), Kenya (95% to 23%), Zambia (87% to 32%), and Zimbabwe (86% to 55%); but coverage increased in 2023 (post-pandemic) in Kenya (71%), Senegal (83%), and Zambia (40%). The estimates of vaccinated children increased steadily over the years, reaching 23.5 million in 2023. However, 257.8 million children missed vaccination between 2012 and 2023, of which 18.5 million in 2022., Conclusions: Although countries in the WHO/AFR have made significant progress in introducing rotavirus vaccines, reaching every eligible child remains a challenge; and more than half of children are missing the full benefit of protection against rotavirus diarrhoea. There is a need for accelerated actions and concerted efforts to reach missed children and support for the nine remaining countries to introduce the vaccine., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier Ltd.)
Published: 2025
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48. Paediatric healthcare in Manhiça district through a gender lens: a retrospective analysis of 17 years of morbidity and demographic surveillance data.

Author: Balanza N, Hunguana A, Ajanovic S, Varo R, Bramugy J, Matsena T, Nhampossa T, Ouchi D, Nhacolo A, Dalsuco J, Sitoe A, Quintó L, Acácio S, Nhacolo A, Maixenchs M, Munguambe K, Mandomando I, Aide P, Saúte F, Guinovart C, Sacoor C, and Bassat Q
Subjects: Humans, Male, Female, Retrospective Studies, Child, Child, Preschool, Infant, Adolescent, Mozambique epidemiology, Sex Factors, Health Services Accessibility statistics & numerical data, Morbidity trends, Population Surveillance, Infant, Newborn, Child Health Services statistics & numerical data, Hospitalization statistics & numerical data
Abstract: Background: Sex and gender are important determinants of health. Gender-based health inequities in the paediatric population have been reported in various countries, but data remain limited. In Mozambique, research on this topic is very scarce. Here we aimed to explore whether boys and girls in Manhiça district, southern Mozambique, differ in access to and provision of healthcare., Methods: This retrospective analysis includes data on all paediatric (<15 years old) visits to six outpatient clinics and admissions to one hospital in Manhiça district from 2004 to 2020, collected through the morbidity surveillance system of the Manhiça Health and Demographic Surveillance System (HDSS). We compared characteristics and outcomes between boys and girls using descriptive statistics, standardised mean differences, and logistic regression. Post-discharge events were analysed using Cox proportional hazards regression and Fine-Gray competing risk regression. Minimum community-based incidence rates of outpatient clinic visits and hospitalisations were calculated using demographic surveillance data from the Manhiça HDSS and analysed with negative binomial regression., Results: Girls represented 49.2% (560 630 out of 1 139 962) of paediatric visits to outpatient clinics and 45.1% (18 625 out of 41 278) of hospitalisations. The girls-to-boys incidence rate ratio (IRR) for hospitalisations was 0.81 (95% confidence interval (CI) = 0.79-0.84). Both boys and girls experienced symptoms for a median duration of one day (interquartile range (IQR) = 1-2) before seeking care. Severe manifestations at presentation to an outpatient clinic or upon hospitalisation tended to be less frequent in girls (girls-to-boys odds ratios (ORs) = 0.71-1.11). Girls were less frequently referred or admitted to hospital after an outpatient clinic visit (OR = 0.82; 95% CI = 0.79-0.86 and OR = 0.85; 95% CI = 0.84-0.87, respectively). The hospital case fatality ratio was 4.1% in boys and 4.2% in girls. The median duration of hospitalisation was three days (IQR = 2-5) and did not differ between boys and girls. Revisits to outpatient clinics, hospital readmissions, and hospital post-discharge mortality were similar in both groups., Conclusions: Girls had fewer referrals and admissions to hospital in Manhiça district, but they were also less likely to present with severe manifestations. Other studied indicators of healthcare access and provision were overall similar for boys and girls. Further research is needed to continue assessing potential gender biases and sex differences in paediatric healthcare in Mozambique., Competing Interests: Disclosure of interests: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests., (Copyright © 2025 by the Journal of Global Health. All rights reserved.)
Published: 2025
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49. Effect of the Ten-valent Pneumococcal Conjugate Vaccine on Invasive Pneumococcal Disease and Pneumonia in Infants Younger Than Ten Weeks of Age in Southern Mozambique: A Population-based Prospective Surveillance Study.

Author: Massora S, Mucavele H, Carvalho MDG, Mandomando I, Chaúque A, Moiane B, Tembe N, Omer SB, Bassat Q, Verani JR, Menéndez C, Quintó L, Sigaúque B, and Bardají A
Subjects: Humans, Mozambique epidemiology, Infant, Prospective Studies, Incidence, Female, Male, Infant, Newborn, Pneumonia, Pneumococcal epidemiology, Pneumonia, Pneumococcal prevention & control, Pneumococcal Vaccines administration & dosage, Pneumococcal Infections epidemiology, Pneumococcal Infections prevention & control, Pneumococcal Infections microbiology, Streptococcus pneumoniae immunology
Abstract: Background: Mozambique introduced 10-valent-pneumococcal conjugate vaccine (PCV10) in 2013. We aimed to evaluate the indirect effect of PCV10 on invasive pneumococcal disease (IPD) and clinical severe pneumonia (CSP) in infants aged less than 10 weeks., Methods: Routine surveillance data for IPD and CSP among admitted infants less than 10 weeks of age were analyzed to compare IPD and CSP incidence using demographic surveillance data from pre- and post-PCV10 periods. IPD was defined as isolation of pneumococcus from blood or cerebrospinal fluid, and CSP according to World Health Organization criteria., Results: The incidence of IPD and CSP among infants less than 10 weeks decreased by 87% [incidence rate ratio (IRR): 0.13; 95% confidence interval (CI): 0.02-0.95] from 283/100,000 in the pre-PCV to 36/100,000 children year at risk (CYAR) post-PCV, and by 62% (IRR: 0.38; 95% CI: 0.27-0.52) from 4100/100,000 pre-PCV to 1550/100,000 CYAR post-PCV periods, respectively. Vaccine-type IPD incidence declined by 92% (IRR: 0.18; 95% CI: 0.02-1.34) from 205/100,000 pre-PCV to 36/100,000 CYAR post-PCV, though the reduction was not statistically significant. The mortality rate due to IPD among infants less than 10 weeks declined from 47/100,000 CYAR in the pre-PCV to 0 in the post-PCV period. Mortality due to CSP declined by 29% (IRR: 0.71; 95% CI: 0.34-1.50), from 457/100,000 CYAR in the pre-PCV to 324/100,000 in the post-PCV periods., Conclusions: PCV10 introduction led to substantial declines in the incidence of IPD, CSP and associated mortality in infants too young to be vaccinated (less than 10 weeks) in Mozambique, suggesting indirect protection., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)
Published: 2025
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50. Albendazole-ivermectin co-formulation for the treatment of Trichuris trichiura and other soil-transmitted helminths: a randomised phase 2/3 trial.

Author: Krolewiecki A, Kepha S, Fleitas PE, van Lieshout L, Gelaye W, Messa A Jr, Gandasegui J, Algorta J, Novela V, de Jesus Á, Rono M, Degarege D, Bedane D, Mwahanje J, Mandomando I, Mwandawiro C, Enbiale W, and Muñoz J
Abstract: Background: Treatments for soil-transmitted helminthiases face challenges, especially in addressing Trichuris trichiura. Combination regimens, particularly of ivermectin and albendazole, are promising. We aimed to assess the safety, efficacy, and palatability of a combination tablet for the treatment of T trichiura, hookworm, and Strongyloides stercoralis infections among school-aged children in Ethiopia, Kenya, and Mozambique., Methods: We conducted an adaptive phase 2/3, randomised, parallel-group, active-controlled, superiority trial in 15 schools in Ethiopia, Kenya, and Mozambique. Eligible participants for both phases were aged 5-18 years, weighed at least 15 kg, and were infected with T trichiura, hookworms, or S stercoralis. Participants were randomly assigned via a computer-generated sequence to either a single dose of a fixed-dose combination (FDC×1) of albendazole (400 mg) plus ivermectin (9 mg or 18 mg), three consecutive daily doses of an FDC (FDC×3) of albendazole (400 mg) plus ivermectin (9 mg or 18 mg), or a single dose of albendazole alone (400 mg) via block randomisation, stratified by soil-transmitted helminth species. Participants and those administering the treatments were not masked to treatment assignment, but those assessing the outcomes were masked. The primary outcome of phase 2 (conducted in Kenya only) was safety during the first 3 h after the intervention and for 7 days, and the primary outcome of phase 3 was efficacy (ie, the proportion of individuals cured at day 21 out of the total number infected at baseline) for T trichiura; both primary outcomes were analysed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT05124691, and is terminated., Findings: Between Jan 20, 2022, and March 24, 2023, 1001 participants were recruited (465 [46%] were female and 536 [54%] were male). 636 (64%) were infected with T trichiura, 360 (36%) with hookworm, and 104 (10%) with S stercoralis; 94 (9%) of 1001 participants had co-infections and were included in the analysis of each infecting species. A total of 243 participants were allocated to the albendazole group, 381 to the FDC×1 group, and 377 to the FDC×3 group. In both phase 2 and 3, gastrointestinal symptoms were the most common mild-to-moderate adverse events in the FDC groups, but resolved within 48 h without intervention. At least one treatment-related adverse event occurred in 34 (14%) of 243 participants in the albendazole group, 75 (20%) of 381 participants in the FDC×1 group, and 88 (23%) of 377 participants in the FDC×3 group. No serious adverse events occurred. For T trichiura, both FDC groups had a higher cure rate (97·2% [95% CI 95·2- 99·3] for FDC×3 and 82·9% [78·2-87·5] for FDC×1) than albendazole (35·9% [27·7-44·1]), with absolute differences of 61·3% (98% CI 50·2-71·2) and 47·0% (34·7-58·1), respectively. For hookworms, FDC×3 had a higher cure rate (95·0% [95% CI 91·1-98·9]) than albendazole (65·1% [56·0-74·2]), with absolute differences of 29·9% (98% CI 17·2-42·4), whereas FDC×1 had a similar cure rate (79·8% [72·8-86·9]) to albendazole. The sample size for efficacy evaluation of S stercoralis was not met., Interpretation: An FDC of albendazole plus ivermectin has a similar safety profile but superior efficacy to albendazole alone against T trichiura infection and hookworms. These findings open opportunities for control of all soil-transmitted helminth species of interest, including potentially S stercoralis. Evaluation of safety in larger populations and implementation scenarios are the next steps for this innovation to promote its incorporation into programmatic activities., Funding: The European and Developing Clinical Trials Partnership., Translation: For the Portuguese translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests JA is an employee of Laboratorios Liconsa. All other authors declare no competing interests., (Copyright © 2025 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)
Published: 2025
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